Provider Demographics
NPI:1508110990
Name:MAHARAJA, BINAL KIRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BINAL
Middle Name:KIRAN
Last Name:MAHARAJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 W SUPERIOR ST
Mailing Address - Street 2:APT 4216
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-8803
Mailing Address - Country:US
Mailing Address - Phone:347-882-3174
Mailing Address - Fax:
Practice Address - Street 1:1 E SUPERIOR
Practice Address - Street 2:SUITE 306
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-8856
Practice Address - Country:US
Practice Address - Phone:312-754-9404
Practice Address - Fax:312-754-9402
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361408462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036140846OtherIL LICENSE NUMBER