Healthcare Provider Details

I. General information

NPI: 1023166311
Provider Name (Legal Business Name): ROBERT J KASH, M.D., S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 W ARCHER AVE
CHICAGO IL
60638-2438
US

IV. Provider business mailing address

6545 W ARCHER AVE
CHICAGO IL
60638-2438
US

V. Phone/Fax

Practice location:
  • Phone: 773-229-8505
  • Fax: 773-229-1878
Mailing address:
  • Phone: 773-229-8505
  • Fax: 773-229-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT J KASH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 773-229-8505