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NPI Code Detail

MEDICARE: PRASANNA ISAAC M.D.

MEDICARE: PRASANNA ISAAC M.D.
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
1207RN0300XNephrology Physician35.095468OH
2207RN0300XNephrology Physician01067936AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881899276
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRASANNA ISAAC M.D.
Provider Business Mailing Address
First Line : 120 W 22ND ST
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1557
Country : US
Telephone Number : 630-573-5000
Fax Number :
Provider Business Practice Location Address
First Line : 7836 W JEFFERSON BLVD STE 101
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4178
Country : US
Telephone Number : 260-494-3484
Fax Number : 260-471-5507
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2007
Last Update Date : 08/15/2024

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Directions to “ PRASANNA ISAAC M.D.” Practice Location

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