Organization
CRYSTAL KANNANKERIL, PSYD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL KANNANKERIL (FOUNDER AND SOLE PRACTITIONER)
(312) 834-3076
Entity
Organization
Contact information
Practice address
30 N MICHIGAN AVE STE 502, CHICAGO, IL 60602-3834
(312) 834-3076
Mailing address
30 N MICHIGAN AVE STE 502, CHICAGO, IL 60602-3834
(312) 834-3076
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
071008430
IL
Other
Enumeration date
09/27/2017
Last updated
07/21/2022
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