Healthcare Provider Details

I. General information

NPI: 1538737127
Provider Name (Legal Business Name): RICHA VAKHARIA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2021
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1732 W HUBBARD ST STE 1D
CHICAGO IL
60622-6271
US

IV. Provider business mailing address

1732 W HUBBARD ST STE 1D
CHICAGO IL
60622-6271
US

V. Phone/Fax

Practice location:
  • Phone: 773-270-3795
  • Fax: 773-770-3464
Mailing address:
  • Phone: 773-270-3795
  • Fax: 773-770-3464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number071.022458
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.022458
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: