Healthcare Provider Details

I. General information

NPI: 1861561292
Provider Name (Legal Business Name): MOHANA K NAIDU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 LARKIN AVE SUITE 202
ELGIN IL
60123
US

IV. Provider business mailing address

2050 LARKIN AVE SUITE 202
ELGIN IL
60123
US

V. Phone/Fax

Practice location:
  • Phone: 847-697-2400
  • Fax: 847-697-2438
Mailing address:
  • Phone: 847-697-2400
  • Fax: 847-697-2438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036077537
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: