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NPI Code Detail

MEDICARE: NIKHITA MOOLAYIL

MEDICARE:   NIKHITA  MOOLAYIL
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
1103TC0700XClinical Psychologist071011200IL

General Provider Information

NPI Number : 1356959332
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKHITA MOOLAYIL
Provider Business Mailing Address
First Line : 2715 N CENTRAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1351
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2715 N CENTRAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1351
Country : US
Telephone Number : 773-360-1389
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2020
Last Update Date : 03/27/2025

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Directions to “ NIKHITA MOOLAYIL ” Practice Location

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