Individual provider Active NPI

Kanchan Rani Parkash, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1396524401
Registry record updated Nov 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.011026 Issued in IL
Practice address
333 N Michigan Ave Ste 2400
Chicago, IL 60601-4040
Phone
(773) 609-0361
NPI assigned
Sep 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.011026 IL Primary

Addresses

Primary practice location

333 N Michigan Ave Ste 2400
Chicago, IL 60601-4040

Mailing address

333 N Michigan Ave Ste 2400
Chicago, IL 60601-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 11, 2024 through Dec 11, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071.011026ILMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700352000000",
    "number": "1396524401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606014040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606014040",
            "telephone_number": "773-609-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKASH",
        "first_name": "KANCHAN",
        "middle_name": "RANI",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-11-19",
        "certification_date": "2023-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.011026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.