Provider Demographics
NPI:1750680120
Name:KASI, REKHA BANDLA (DO)
Entity Type:Individual
Prefix:DR
First Name:REKHA
Middle Name:BANDLA
Last Name:KASI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:REKHA
Other - Middle Name:
Other - Last Name:BANDLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2150 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3706
Mailing Address - Country:US
Mailing Address - Phone:312-942-7498
Mailing Address - Fax:312-942-3186
Practice Address - Street 1:2150 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-942-7498
Practice Address - Fax:312-942-3186
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361378442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry