Provider Demographics
NPI:1730389552
Name:OZA, KRUTI YOGESH KUMAR (PT)
Entity type:Individual
Prefix:
First Name:KRUTI
Middle Name:YOGESH KUMAR
Last Name:OZA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-6200
Mailing Address - Fax:
Practice Address - Street 1:3430 GRAND AVE
Practice Address - Street 2:#400
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3741
Practice Address - Country:US
Practice Address - Phone:847-782-9860
Practice Address - Fax:847-782-9866
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070017126225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist