Healthcare Provider Details

I. General information

NPI: 1801706007
Provider Name (Legal Business Name): PRISM DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 E PALATINE RD STE 107
PALATINE IL
60067-5131
US

IV. Provider business mailing address

119 E PALATINE RD STE 107
PALATINE IL
60067-5131
US

V. Phone/Fax

Practice location:
  • Phone: 888-910-0640
  • Fax: 888-446-4118
Mailing address:
  • Phone: 888-910-0640
  • Fax: 888-446-4118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAI GOUTHAM REDDY KATTA
Title or Position: OWNER
Credential:
Phone: 888-446-4118