Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 036157688 | IL |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 60856 | TN |
N | 207YS0123X | Facial Plastic Surgeon | 60856 | NY |
NPI | 1619362795 |
---|---|
Provider Name | Dr. Karthik Shastri |
First Address | Glenview, IL 60026-8039 |
Second Address | Glenview, IL 60026-8039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2015 |
Last Update Date | 28/10/2021 |