Healthcare Provider Details

I. General information

NPI: 1457177495
Provider Name (Legal Business Name): PRATIBHA ADHIKARI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N HARLEM AVE
OAK PARK IL
60302-1805
US

IV. Provider business mailing address

6348 N MILWAUKEE AVE # 390
CHICAGO IL
60646-3728
US

V. Phone/Fax

Practice location:
  • Phone: 847-235-6130
  • Fax: 847-235-6135
Mailing address:
  • Phone: 847-235-6130
  • Fax: 847-235-6135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209030901
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: