Health Department

NPI 1447418017 - Clinic/Center - 261QC1500X

NPI Details
NPI 1447418017
Enumeration Date 05/29/2008
Last Updated 05/29/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name PRATHIBHA V PRATHIBHA
Position PEDIATRICIAN
Phone (773) 667-4631
Fax
Practice Location
5400 S HYDE PARK BLVD APT D2
CHICAGO IL, 60615-5852, US
Phone (773) 667-4631
Fax
Business Location
5400 S HYDE PARK BLVD APT D2
CHICAGO IL, 60615-5852, US
Phone (773) 667-4631
Fax
Toxanomy
Taxonomy Code 261QC1500X
License State Illinois
License Number 036048048
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According to our database, Health Department NPI is 1447418017, taxonomy code is 261QC1500X and license number is 036048048, license state is located at Illinois. Health Department physically located at 5400 S Hyde Park Blvd Apt D2, Chicago IL, 60615-5852. NPI Number 1033115704 has the healthcare provider type.

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1447418017 NPI number is provided on an as is basis without warranty of any kind. 1447418017 is maintained by the National Plan & Provider Enumeration System. The contents of Health Department are for informational purposes only.