Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 071008056 | IL |
Y | 103TC0700X | Clinical Psychologist | 071008056 | IL |
N | 103G00000X | Clinical Psychologist | 22361 | CA |
N | 103TC0700X | Clinical Psychologist | 22361 | CA |
NPI | 1003965930 |
---|---|
Provider Name | Dr. Sunitha Rachel Chandy |
First Address | Chicago, IL 60622-1703 |
Second Address | Chicago, IL 60603-4955 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 17/03/2018 |