Basic Information
Provider Information
NPI: 1982982096
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SOOD
FirstName: KANIKA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1501 S CALIFORNIA AVE
Address2:  
City: CHICAGO
State: IL
PostalCode: 606081732
CountryCode: US
TelephoneNumber: 7735422000
FaxNumber:  
Practice Location
Address1: 26460 NETWORK PL
Address2:  
City: CHICAGO
State: IL
PostalCode: 606731264
CountryCode: US
TelephoneNumber: 7732572773
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/25/2011
LastUpdateDate: 07/11/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VX0000X036137848ILY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics

ID Information
IDTypeStateIssuerDescription
106577060101CTUNITED HEALTH CAREOTHER


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