Provider Demographics
NPI:1518222967
Name:TANEJA, AANCHAL
Entity Type:Individual
Prefix:MISS
First Name:AANCHAL
Middle Name:
Last Name:TANEJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 N SHEFFIELD AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-2212
Mailing Address - Country:US
Mailing Address - Phone:312-285-1482
Mailing Address - Fax:
Practice Address - Street 1:3315 N SHEFFIELD AVE
Practice Address - Street 2:APT 2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-2212
Practice Address - Country:US
Practice Address - Phone:312-285-1482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation