MEDICARE: KARSHANDAS KACHA M.D.

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	207Q00000X	Family Medicine Physician	036.056764	IL

General Provider Information

NPI Number	:	1730517996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARSHANDAS KACHA M.D.

Provider Business Mailing Address
First Line	:	910 S MICHIGAN AVE
Second Line	:	UNIT # 1606
City	:	CHICAGO
State	:	IL
Zip	:	60605-2356
Country	:	US
Telephone Number	:	312-753-5283
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 S MICHIGAN AVE
Second Line	:	APT # 1606
City	:	CHICAGO
State	:	IL
Zip	:	60605-2356
Country	:	US
Telephone Number	:	312-753-5283
Fax Number	:

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

Provider Enumeration Date	:	10/28/2013
Last Update Date	:	10/28/2013

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