Provider Demographics
NPI:1063896819
Name:CHAKRABARTY, ARINDAM (MD)
Entity type:Individual
Prefix:
First Name:ARINDAM
Middle Name:
Last Name:CHAKRABARTY
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 1:901 W JEFFERSON ST
Mailing Address - Street 2:SIU PSYCHIATRY
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62702-4833
Mailing Address - Country:US
Mailing Address - Phone:217-761-8669
Mailing Address - Fax:
Practice Address - Street 1:901 W JEFFERSON ST
Practice Address - Street 2:SIU PSYCHIATRY
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702-4833
Practice Address - Country:US
Practice Address - Phone:217-761-8669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-11
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1250673002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry