MEDICARE: ASHWINI KRISHNAKUMAR

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	101Y00000X	Counselor	178009562	IL

General Provider Information

NPI Number	:	1912381757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHWINI KRISHNAKUMAR

Provider Business Mailing Address
First Line	:	3418 W DRUMMOND PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-1212
Country	:	US
Telephone Number	:	630-544-4077
Fax Number	:

Provider Business Practice Location Address
First Line	:	3418 W DRUMMOND PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-1212
Country	:	US
Telephone Number	:	630-544-4077
Fax Number	:

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

Provider Enumeration Date	:	07/10/2015
Last Update Date	:	07/10/2015

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Directions to “ ASHWINI KRISHNAKUMAR ” Practice Location

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