MEDICARE: PRISM DIAGNOSTICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1578411039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRISM DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	119 E PALATINE RD STE 107
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-5131
Country	:	US
Telephone Number	:	888-446-4118
Fax Number	:	888-910-0640

Provider Business Practice Location Address
First Line	:	119 E PALATINE RD STE 107
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-5131
Country	:	US
Telephone Number	:	888-446-4118
Fax Number	:	888-910-0640

Authorized Official
Title or Position	:	OWNER
Name	:	SAI GOUTHAM REDDY KATTA
Credential	:
Telephone Number	:	888-446-4118

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	05/21/2026

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Directions to “PRISM DIAGNOSTICS LLC ” Practice Location

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