Provider Demographics
NPI:1407559537
Name:KAKADIA, ROOTUL (DO)
Entity Type:Individual
Prefix:
First Name:ROOTUL
Middle Name:
Last Name:KAKADIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 FIELDSTONE LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-1802
Mailing Address - Country:US
Mailing Address - Phone:630-407-7055
Mailing Address - Fax:
Practice Address - Street 1:1127 FIELDSTONE LN
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-1802
Practice Address - Country:US
Practice Address - Phone:630-407-7055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program