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Individual

PRASANTH BOBBY KATTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2111 MIDLANDS CT, SYCAMORE, IL 60178-3125
(815) 758-0000
(815) 756-7130
Mailing address
2111 MIDLANDS CT, SYCAMORE, IL 60178-3125
(815) 758-0000
(815) 756-7130

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
FK5377355
KY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036154765
IL
208100000X
Physical Medicine & Rehabilitation Physician
R3525
KY
208VP0000X
Pain Medicine Physician
036154765
IL

Other

Enumeration date
06/27/2014
Last updated
04/23/2024
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