Provider Demographics
NPI:1578210571
Name:KANNAN VINAITHEERTHAN, INC.
Entity Type:Organization
Organization Name:KANNAN VINAITHEERTHAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/ PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KANNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VINAITHEERTHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-615-1670
Mailing Address - Street 1:6421 N TRUMBULL AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3820
Mailing Address - Country:US
Mailing Address - Phone:630-615-1670
Mailing Address - Fax:
Practice Address - Street 1:6421 N TRUMBULL AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-3820
Practice Address - Country:US
Practice Address - Phone:630-615-1670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty