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General NPI Number Information
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NPI Number | 1396053070
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Entity Type | Organization
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Legal Business Name | SHIPRA S. PARIKH, PH.D., LLC
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 111 N WABASH AVE SUITE 1904
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City | CHICAGO
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State | IL
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Zip | 60602-1903
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Country | US
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Telephone | 312-339-9345
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Fax |
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Provider Business Mailing Address
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Address Line | 1369 W CRYSTAL ST UNIT 4
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City | CHICAGO
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State | IL
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Zip | 60642-3382
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Country | US
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Telephone | 312-339-9345
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | DR. SHIPRA SHARADA PARIKH
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Credential | PH.D., LCSW
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Telephone | 312-339-9345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149011632
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License Number State | IL
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