Basic Information
| Provider Information | |||||||||
| NPI: | 1326482688 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOLANI | ||||||||
| FirstName: | ANMOL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7410264 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606740264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8159426323 | ||||||||
| FaxNumber: | 7792105541 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 N WABASH AVE STE 1116 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606023126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8159426323 | ||||||||
| FaxNumber: | 7792105541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2013 | ||||||||
| LastUpdateDate: | 02/23/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 036.144646 | IL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 036144646 | 05 | IL | MEDICAID |