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Organization

CREATING CONNECTIONS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MANISHA DAYAL PSY.D. (OWNER/CLINICAL PSYCHOLOGIST)
(773) 297-2696
Entity
Organization

Contact information

Practice address
1300 W BELMONT AVE STE 407, CHICAGO, IL 60657-3242
(773) 297-2696
Mailing address
1300 W BELMONT AVE STE 407, CHICAGO, IL 60657-3242
(773) 297-2696

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071005780
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01622706
BLUE CROSS BLUE SHIELD PPO
IL
Enumeration date
01/02/2014
Last updated
01/02/2014
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