| Artesian Collaborative, Llc | |
|
77 W Washington St Ste 1500 Chicago IL 60602-3219 | |
| (773) 980-9679 | |
| Not Available |
| Full Name | Artesian Collaborative, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 77 W Washington St Ste 1500, Chicago, Illinois |
| Authorized Official Name and Position | Sunitha Rachel Chandy (OWNER) |
| Authorized Official Contact | 7739809679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Artesian Collaborative, Llc 1402 N Artesian Ave Chicago IL 60622-1703 Ph: (408) 802-3968 | Artesian Collaborative, Llc 77 W Washington St Ste 1500 Chicago IL 60602-3219 Ph: (773) 980-9679 |
| NPI Number | 1487170007 |
|---|---|
| Provider Enumeration Date | 08/15/2017 |
| Last Update Date | 07/19/2022 |
| Certification Date | 09/23/2021 |
| Medicare PECOS PAC ID | 2365831609 |
|---|---|
| Medicare Enrollment ID | O20211108002376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487170007 | NPI | - | NPPES |
| Provider Name | Sunitha Chandy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003965930 PECOS PAC ID: 9830375104 Enrollment ID: I20110520000651 |
| Provider Name | Megan Z Reddy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467649004 PECOS PAC ID: 7012162639 Enrollment ID: I20131220000043 |
| Provider Name | Ben Durchslag |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407144421 PECOS PAC ID: 1254790413 Enrollment ID: I20230706000815 |
| Provider Name | Sithara Stohr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093440935 PECOS PAC ID: 4981065901 Enrollment ID: I20230807001668 |
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