Individual
VASANTH KATTALAI KAILASAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
875 SOUTH ROUTE 31, CRYSTAL LAKE, IL 60014
(779) 220-5500
Mailing address
43 WHITING HILL RD STE 300, BREWER, ME 04412-1006
Taxonomy
Speciality
Code
Description
License number
State
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
60723587
WA
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
MD21916
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/30/2012
Last updated
10/02/2023
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