Provider Demographics
NPI:1962515056
Name:ANAND, JOLLY C (MD)
Entity type:Individual
Prefix:
First Name:JOLLY
Middle Name:C
Last Name:ANAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:8900 S COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-6321
Mailing Address - Country:US
Mailing Address - Phone:312-565-2251
Mailing Address - Fax:630-214-2094
Practice Address - Street 1:10551 S EWING AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-6220
Practice Address - Country:US
Practice Address - Phone:312-565-2251
Practice Address - Fax:630-214-2094
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL233400Medicare ID - Type Unspecified
ILF84410Medicare UPIN