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Individual

ANISH JOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
680 N LAKE SHORE DR STE 800, CHICAGO, IL 60611-8701
(312) 973-1988
Mailing address
680 N. LAKE SHORE DR STE 800, CHICAGO, IL 60611
(312) 973-1988

Taxonomy

Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
Primary
036140599
IL
2084P0802X
Addiction Psychiatry Physician
276491
NY

Other

Enumeration date
12/08/2011
Last updated
07/18/2017
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