Provider Demographics
NPI:1396053070
Name:SHIPRA S. PARIKH, PH.D., LLC
Entity type:Organization
Organization Name:SHIPRA S. PARIKH, PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIPRA
Authorized Official - Middle Name:SHARADA
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:312-339-9345
Mailing Address - Street 1:1369 W CRYSTAL ST
Mailing Address - Street 2:UNIT 4
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-3382
Mailing Address - Country:US
Mailing Address - Phone:312-339-9345
Mailing Address - Fax:
Practice Address - Street 1:111 N WABASH AVE
Practice Address - Street 2:SUITE 1904
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1903
Practice Address - Country:US
Practice Address - Phone:312-339-9345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490116321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty