Healthcare Provider Details

I. General information

NPI: 1811308034
Provider Name (Legal Business Name): AKASH KATARUKA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2014
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13011 S 104TH AVE STE 100
PALOS PARK IL
60464-1508
US

IV. Provider business mailing address

13011 S 104TH AVE STE 100
PALOS PARK IL
60464-1508
US

V. Phone/Fax

Practice location:
  • Phone: 708-274-3278
  • Fax:
Mailing address:
  • Phone: 708-274-3278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number036.174909
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: