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General NPI Number Information
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NPI Number | 1144713348
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Entity Type | Individual
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Provider Name | KEVIN M PRESCOTT MD
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Gender | Male
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 1800 HOLLISTER DR STE 112
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-5265
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Country | US
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Telephone | 847-367-6781
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Fax | 847-367-8008
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone | 847-390-5900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 036155652
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License Number State | IL
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