Individual
MAANASA BANDLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1747 W ROOSEVELT RD, CHICAGO, IL 60608-1264
(312) 996-9593
Mailing address
720 HARRISON AVE FL 9, BOSTON, MA 02118-2371
(617) 638-8540
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0102208150
VA
2084P0800X
Psychiatry Physician
Primary
036170900
IL
2084P0800X
Psychiatry Physician
281143
MA
2084P0804X
Child & Adolescent Psychiatry Physician
036.170900
IL
Other
Enumeration date
03/21/2019
Last updated
11/21/2025
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