Healthcare Provider Details

I. General information

NPI: 1326304015
Provider Name (Legal Business Name): SAI PSYCHIATRY SERVICES, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 04/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24012 W RENWICK RD SUIT 204B
PLAINFIELD IL
60544-8731
US

IV. Provider business mailing address

PO BOX 1467
PLAINFIELD IL
60544-3467
US

V. Phone/Fax

Practice location:
  • Phone: 630-839-9334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. TANMOY CHANDRA
Title or Position: PRESIDENT
Credential:
Phone: 630-839-9334