Individual provider Active NPI

Pramila Kasturi, MD

  • Internal Medicine Physician
  • Gurnee, IL
National Provider Identifier
1245240936
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036105457 Issued in IL
Practice address
15 Tower CT Ste 240
Gurnee, IL 60031-3336
Phone
(847) 249-1606
Fax
(847) 249-1609
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036105457 IL Primary

Addresses

Primary practice location

15 Tower CT Ste 240
Gurnee, IL 60031-3336

Mailing address

PO Box 291
Wauconda, IL 60084-0291
Phone (847) 249-1606

Other identifiers 1

IdentifierTypeStateIssuer
036105457MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036105457ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Nephrology, S.C. CurrentSince Jul 1, 2022 Accepting new patients
Advocate Health Centers, Inc. Past Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

15 Tower Ct
Ste 240
Gurnee, IL 60031
Phone (847) 249-1606

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1245240936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600840291",
            "telephone_number": "847-249-1606",
            "fax_number": "847-249-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 TOWER CT STE 240",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313336",
            "telephone_number": "847-249-1606",
            "fax_number": "847-249-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASTURI",
        "first_name": "PRAMILA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036105457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105457",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.