Healthcare Provider Details

I. General information

NPI: 1326663022
Provider Name (Legal Business Name): PRISM HOLISTIC CARE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W GRAND AVE STE 500
CHICAGO IL
60654-6799
US

IV. Provider business mailing address

6505 N LONGMEADOW AVE
LINCOLNWOOD IL
60712-3205
US

V. Phone/Fax

Practice location:
  • Phone: 800-325-1812
  • Fax:
Mailing address:
  • Phone: 773-391-9184
  • Fax: 773-920-3322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MEHBUB KAPADIA
Title or Position: DIRECTOR
Credential: MD
Phone: 773-391-9184