MEDICARE: MR. KAHNU CHARAN DAS O. T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	110560	TX

General Provider Information

NPI Number	:	1295985067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KAHNU CHARAN DAS O. T.

Provider Business Mailing Address
First Line	:	790 REMINGTON BLVD
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60440-4909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5913 LOGAN DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75094-4564
Country	:	US
Telephone Number	:	972-423-7060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2008
Last Update Date	:	03/04/2024

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