Provider Demographics
NPI:1871203174
Name:ARANDA, NIJAH
Entity type:Individual
Prefix:MS
First Name:NIJAH
Middle Name:
Last Name:ARANDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3336 W IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3327
Mailing Address - Country:US
Mailing Address - Phone:773-456-8217
Mailing Address - Fax:
Practice Address - Street 1:2045 W GRAND AVE STE B17739
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-1576
Practice Address - Country:US
Practice Address - Phone:312-448-7310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-16-24662106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL853344992OtherGROUP TAX ID