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General NPI Number Information
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NPI Number | 1093272718
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Entity Type | Organization
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Legal Business Name | KASTURI REHABILITATION LLC
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Dates
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Enumeration Date | 02/28/2019
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Last Update Date | 03/01/2019
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Provider Practice Location Address
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Address Line | 473 W ARMY TRAIL RD STE 106
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2674
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Country | US
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Telephone | 630-935-6581
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Fax |
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Provider Business Mailing Address
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Address Line | 309 ESSEX CT
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-3017
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Country | US
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Telephone | 630-935-6581
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Fax |
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Authorized Official
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Title or Position | ADMIN/OCCUP THERAPIST
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Name | MR. AKSHAY GUPTA
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Credential | MS,OTR/L
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Telephone | 630-935-6581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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