Healthcare Provider Details

I. General information

NPI: 1982982096
Provider Name (Legal Business Name): KANIKA SOOD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4121 FAIRVIEW AVE
DOWNERS GROVE IL
60515-2264
US

IV. Provider business mailing address

1501 S CALIFORNIA AVE
CHICAGO IL
60608-1732
US

V. Phone/Fax

Practice location:
  • Phone: 312-288-5019
  • Fax:
Mailing address:
  • Phone: 773-542-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number036137848
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: