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General NPI Number Information
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NPI Number | 1073085379
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Entity Type | Individual
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Provider Name | YASH KAUSHIK
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Gender | Male
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Dates
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Enumeration Date | 12/26/2018
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Last Update Date | 12/26/2018
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Provider Practice Location Address
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Address Line | 1251 E RICHTON RD
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City | CRETE
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State | IL
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Zip | 60417-1623
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Country | US
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Telephone | 708-539-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 19422 LISADELL DR
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City | TINLEY PARK
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State | IL
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Zip | 60487-4473
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Country | US
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Telephone | 708-539-5200
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Fax | 708-554-1980
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251E1300X
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Taxonomy Name | Clinical Electrophysiology Physical Therapist
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License Number | 070020308
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License Number State | IL
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