Healthcare Provider Details

I. General information

NPI: 1811843659
Provider Name (Legal Business Name): DIVYA CHAND LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W BELMONT AVE STE 400C
CHICAGO IL
60657-3200
US

IV. Provider business mailing address

1500 W FARWELL AVE APT 1
CHICAGO IL
60626-3666
US

V. Phone/Fax

Practice location:
  • Phone: 773-922-0304
  • Fax:
Mailing address:
  • Phone: 312-574-0363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.029055
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: