Provider Demographics
NPI:1154582385
Name:ANANDAPPA, CHRISANTHA ERNEST (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISANTHA
Middle Name:ERNEST
Last Name:ANANDAPPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 ASBURY AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2135
Mailing Address - Country:US
Mailing Address - Phone:708-557-1930
Mailing Address - Fax:
Practice Address - Street 1:1007 CHURCH ST STE 312
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-5912
Practice Address - Country:US
Practice Address - Phone:844-215-4468
Practice Address - Fax:877-428-7891
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1327342084P0800X
MI43010923152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty