Provider Demographics
NPI:1093272718
Name:KASTURI REHABILITATION LLC
Entity Type:Organization
Organization Name:KASTURI REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN/OCCUP THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AKSHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MS,OTR/L
Authorized Official - Phone:630-935-6581
Mailing Address - Street 1:309 ESSEX CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-3017
Mailing Address - Country:US
Mailing Address - Phone:630-935-6581
Mailing Address - Fax:
Practice Address - Street 1:473 W ARMY TRAIL RD STE 106
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2674
Practice Address - Country:US
Practice Address - Phone:630-935-6581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty