MEDICARE: DOWNTOWN PSYCHIATRY CHICAGO PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician
2	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1184518169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOWNTOWN PSYCHIATRY CHICAGO PLLC

Provider Business Mailing Address
First Line	:	30 N MICHIGAN AVE STE 703
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-3816
Country	:	US
Telephone Number	:	312-625-3551
Fax Number	:	312-625-3552

Provider Business Practice Location Address
First Line	:	30 N MICHIGAN AVE STE 703
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-3816
Country	:	US
Telephone Number	:	312-625-3551
Fax Number	:	312-625-3552

Authorized Official
Title or Position	:	PSYCHIATRIST
Name	:	DR. SUDHAKAR SHENOY
Credential	:	MD, FAPA
Telephone Number	:	312-625-3551

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/05/2025

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