Provider Demographics
NPI:1790376366
Name:CBT CENTER OF CHICAGO, PLLC
Entity Type:Organization
Organization Name:CBT CENTER OF CHICAGO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEEPIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-999-8493
Mailing Address - Street 1:2515 W LAWRENCE AVE APT 3N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3679
Mailing Address - Country:US
Mailing Address - Phone:847-999-8493
Mailing Address - Fax:
Practice Address - Street 1:5620 S BLACKSTONE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1828
Practice Address - Country:US
Practice Address - Phone:773-850-3715
Practice Address - Fax:773-825-8274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty