MEDICARE: ANDREW J. SARKISIAN PSYD

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	103TC0700X	Clinical Psychologist	071.022433	IL

General Provider Information

NPI Number	:	1568156370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW J. SARKISIAN PSYD

Provider Business Mailing Address
First Line	:	552 W ROSCOE ST APT 3A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3528
Country	:	US
Telephone Number	:	559-903-8450
Fax Number	:

Provider Business Practice Location Address
First Line	:	1509 W BERWYN AVE STE 208
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-8060
Country	:	US
Telephone Number	:	773-654-3322
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2023
Last Update Date	:	09/30/2025

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