Provider Demographics
NPI:1457716268
Name:FELDER, AARTI S (MA, LCPC)
Entity type:Individual
Prefix:
First Name:AARTI
Middle Name:S
Last Name:FELDER
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:ARTI
Other - Middle Name:DEO
Other - Last Name:SARUP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4055 W PETERSON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-6183
Mailing Address - Country:US
Mailing Address - Phone:224-518-4547
Mailing Address - Fax:
Practice Address - Street 1:4055 W PETERSON AVE STE 201
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-6183
Practice Address - Country:US
Practice Address - Phone:224-518-4547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-21
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178011606101YP2500X
101YP2500X
IL180011872101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1457716268Medicaid