Provider Demographics
NPI:1245359694
Name:BAHADUR, KARUNA (LCSW)
Entity type:Individual
Prefix:MISS
First Name:KARUNA
Middle Name:
Last Name:BAHADUR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5532 S SHORE DRIVE
Mailing Address - Street 2:#20D
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1999
Mailing Address - Country:US
Mailing Address - Phone:773-241-6108
Mailing Address - Fax:773-251-5724
Practice Address - Street 1:5532 S SHORE DRIVE
Practice Address - Street 2:#20D
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1999
Practice Address - Country:US
Practice Address - Phone:773-241-6108
Practice Address - Fax:773-251-5724
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001605220OtherBLUE CROSS BLUE SHIELD IL