Healthcare Provider Details

I. General information

NPI: 1689786311
Provider Name (Legal Business Name): INDERJOTE S. KATHURIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19W060 AVENUE LATOUR
OAK BROOK IL
60523-1012
US

IV. Provider business mailing address

19W060 AVENUE LATOUR
OAK BROOK IL
60523-1012
US

V. Phone/Fax

Practice location:
  • Phone: 630-915-2852
  • Fax:
Mailing address:
  • Phone: 630-915-2852
  • Fax: 630-214-8899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1298-320
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number1298-320
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME147687
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036096523
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number036096523
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberME147687
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: