Individual
DR. KMLST MOORTHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
90 W 86TH AVE, NEPHROLOGY ASSOCIATES OF NORTHERN INDIANA, MERRILLVILLE, IN 46410-7086
(219) 791-1555
(219) 791-0679
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
(630) 573-5000
(630) 491-5472
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01063457A
IN
207RN0300X
Nephrology Physician
036106618
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200876750
—
IN
Enumeration date
06/01/2005
Last updated
11/18/2024
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