| Doctor Name: | DR. CHINNI CHILAMKURTI |
| NPI Number: | 1093839987 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | |
| Business Practice Address: | 100 S Atkinson Rd Suite 205 Grayslake, IL - 600307817 |
| Business Phone Number: | 8475480024 |
| Business Fax Number: | |
| Mailing Address: | 100 S Atkinson Rd, Suite 205 GRAYSLAKE |
| State: | IL |
| Postal Code: | 600307817 |
| Phone Number: | 8475480024 |
| Fax Number: | |
| NPI Enumeration Date: | 03/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |