Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1518222967 |
---|---|
Provider Name | Miss Aanchal Taneja |
First Address | Chicago, IL 60657-2212 |
Second Address | Chicago, IL 60657-2212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2012 |
Last Update Date | 11/07/2012 |