Organization
KASTURI MEDICAL CARE, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRAMILA KASTURI MD (OWNER)
(224) 210-0471
Entity
Organization
Contact information
Practice address
15 TOWER CT STE 240, GURNEE, IL 60031-3336
(847) 249-1606
(847) 249-1609
Mailing address
PO BOX 291, WAUCONDA, IL 60084-0291
(847) 249-1606
(847) 249-1609
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036105457
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105457
—
IL
01
—
DF7990
RAIL ROAD MEDICARE
IL
Enumeration date
08/08/2006
Last updated
03/10/2015
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