Provider Demographics
NPI:1386428043
Name:RAMKUMAR, KAUSHAL (RN, BSN)
Entity type:Individual
Prefix:
First Name:KAUSHAL
Middle Name:
Last Name:RAMKUMAR
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:KAUSHAL
Other - Middle Name:R
Other - Last Name:SAHEBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7162 N OTTAWA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1001
Mailing Address - Country:US
Mailing Address - Phone:773-858-6711
Mailing Address - Fax:
Practice Address - Street 1:41W400 SILVER GLEN RD
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-8453
Practice Address - Country:US
Practice Address - Phone:331-901-4225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.527065163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse