MEDICARE: DR. SMRITHI-ANN FRANCO CHAKKALAKAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	036152913	IL

General Provider Information

NPI Number	:	1013379155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SMRITHI-ANN FRANCO CHAKKALAKAL M.D.

Provider Business Mailing Address
First Line	:	1440 S WABASH AVE APT 304
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-2898
Country	:	US
Telephone Number	:	469-878-8274
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 W BRADLEY PL STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-4716
Country	:	US
Telephone Number	:	773-649-0759
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2016
Last Update Date	:	11/06/2020

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