Provider Demographics
NPI:1104350198
Name:SUNILA M. RAO, PSY.D., LLC
Entity type:Organization
Organization Name:SUNILA M. RAO, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-791-9185
Mailing Address - Street 1:PO BOX 1142
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-6002
Mailing Address - Country:US
Mailing Address - Phone:847-791-9185
Mailing Address - Fax:
Practice Address - Street 1:720 OSTERMAN AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4471
Practice Address - Country:US
Practice Address - Phone:847-791-9185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006663103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty