Individual
DR. AJITA V. KASBEKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2800 W 95TH ST, EVERGREEN PARK, IL 60805-2746
(708) 422-6200
Mailing address
PO BOX 631, LAKE FOREST, IL 60045-0631
(847) 615-2200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036051158
IL
208VP0014X
Interventional Pain Medicine Physician
036051158
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051158
—
IL
Enumeration date
06/09/2006
Last updated
06/04/2009
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