MEDICARE: ANN RAMAIYA LPC

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	101YM0800X	Mental Health Counselor	178.016128	IL

General Provider Information

NPI Number	:	1407431935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN RAMAIYA LPC

Provider Business Mailing Address
First Line	:	700 N GREEN ST # 303
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5996
Country	:	US
Telephone Number	:	224-552-0655
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 N GREEN ST STE 303
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5996
Country	:	US
Telephone Number	:	224-552-0655
Fax Number	:

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

Provider Enumeration Date	:	03/16/2021
Last Update Date	:	05/06/2022

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Directions to “ ANN RAMAIYA LPC” Practice Location

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