Provider Demographics
NPI:1437576741
Name:BEDI, RITU (PHD)
Entity Type:Individual
Prefix:
First Name:RITU
Middle Name:
Last Name:BEDI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5362 W LAWRENCE AVE
Mailing Address - Street 2:IE
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-3657
Mailing Address - Country:US
Mailing Address - Phone:847-274-9753
Mailing Address - Fax:
Practice Address - Street 1:4803 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2146
Practice Address - Country:US
Practice Address - Phone:847-340-9908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008792103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical