Provider Demographics
NPI:1619293131
Name:CHALLA, KARTHIK KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:KARTHIK
Middle Name:KUMAR
Last Name:CHALLA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1435 N RANDALL RD
Mailing Address - Street 2:STE 201
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123
Mailing Address - Country:US
Mailing Address - Phone:847-695-3168
Mailing Address - Fax:847-695-4289
Practice Address - Street 1:1435 N RANDALL RD
Practice Address - Street 2:STE 201
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123
Practice Address - Country:US
Practice Address - Phone:847-695-3168
Practice Address - Fax:847-695-4289
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-132517207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease