Provider Demographics
NPI:1497043657
Name:KARAKASHIAN, MICHAEL ANTRANIG (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTRANIG
Last Name:KARAKASHIAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:MIKE
Other - Middle Name:A
Other - Last Name:KARAKASHIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:655 WEST IRVING PARK ROAD,
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:655 WEST IRVING PARK ROAD,
Practice Address - Street 2:SUITE 201
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613
Practice Address - Country:US
Practice Address - Phone:773-527-1304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008434103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical