Healthcare Provider Details

I. General information

NPI: 1942461231
Provider Name (Legal Business Name): ANUPAMA NATRAJ WADHWA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 N WESTERN AVE
CHICAGO IL
60659-2009
US

IV. Provider business mailing address

6301 N WESTERN AVE
CHICAGO IL
60659-2009
US

V. Phone/Fax

Practice location:
  • Phone: 773-761-0300
  • Fax:
Mailing address:
  • Phone: 773-761-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number036128716
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036128716
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: