Allen Kodish, M.D.

Primary specialty

PsychoanalystTaxonomy code 102L00000X

License

036057422 Issued in IL

Practice address

1525 E 53Rd St
#802
Chicago, IL 60615-4557

Phone

(312) 332-2101

Fax

(773) 324-8098

NPI assigned

Apr 8, 2012

Last updated

Apr 8, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1333843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333843200000",
    "number": "1851657449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E 53RD ST",
            "address_2": "#802",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154557",
            "telephone_number": "312-332-2101",
            "fax_number": "773-324-8098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 53RD ST",
            "address_2": "#802",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154557",
            "telephone_number": "312-332-2101",
            "fax_number": "773-324-8098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODISH",
        "first_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-08",
        "last_updated": "2012-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "IL",
            "license": "036057422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Konrad Richard Koczwara, P.T.
• Abhigna Kodali, M.D.
• Anita Kodali, MD
• Sileshini Kodali, BDS
• Teresa Wyatt Kodiak, APN-CNP, FNP-C
• Varna Kumar Kodoth, MD
• Anuradha Koduri, M.D.
• Priyadarshini Koduri, M.D.
• Pramoda Koduru, M.D
• Koebers Prosthetic & Orthotic Lab Inc.

• Psychoanalyst in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychoanalyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.