Healthcare Provider Details

I. General information

NPI: 1497978985
Provider Name (Legal Business Name): PRISM MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 E SCHAUMBURG RD
SCHAUMBURG IL
60194-3654
US

IV. Provider business mailing address

825 E SCHAUMBURG RD
SCHAUMBURG IL
60194-3654
US

V. Phone/Fax

Practice location:
  • Phone: 630-539-9900
  • Fax: 630-539-9903
Mailing address:
  • Phone: 630-539-9900
  • Fax: 630-539-9903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateIL

VIII. Authorized Official

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