| Prakash Vaishnav Md | |
|
4 Marissa Ct Burr Ridge IL 60527-6864 | |
| (630) 952-1412 | |
| Not Available |
| Full Name | Prakash Vaishnav Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 4 Marissa Ct, Burr Ridge, Illinois |
| Authorized Official Name and Position | Prakash Vasihnav (PRESIDENT) |
| Authorized Official Contact | 6309521412 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prakash Vaishnav Md 4 Marissa Ct Burr Ridge IL 60527-6864 Ph: () - | Prakash Vaishnav Md 4 Marissa Ct Burr Ridge IL 60527-6864 Ph: (630) 952-1412 |
| NPI Number | 1316600489 |
|---|---|
| Provider Enumeration Date | 10/15/2021 |
| Last Update Date | 05/03/2022 |
| Medicare PECOS PAC ID | 7618366022 |
|---|---|
| Medicare Enrollment ID | O20211104002960 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316600489 | NPI | - | NPPES |
| Provider Name | Prakash Vaishnav |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1770547309 PECOS PAC ID: 3072410422 Enrollment ID: I20031215000779 |
| Provider Name | Karen J Krooswyk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134477706 PECOS PAC ID: 3274760228 Enrollment ID: I20131218001094 |
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