Organization
KASTURI, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYA KASTURI M.D. (OWNER PHYSICIAN)
(630) 718-0200
Entity
Organization
Contact information
Practice address
1111 SUPERIOR ST, SUITE 507, MELROSE PARK, IL 60160-4138
(708) 681-4040
Mailing address
1730 PARK ST, SUITE 101, NAPERVILLE, IL 60563-2688
(630) 718-0200
(630) 718-0900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31602382
BLUE CROSS / BLUE SHIELD
IL
Enumeration date
05/03/2006
Last updated
02/12/2010
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