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NPI Code Detail

MEDICARE: PRISM FOUNDATION

MEDICARE: PRISM FOUNDATION
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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1942147194
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRISM FOUNDATION
Provider Business Mailing Address
First Line : 6505 N LONGMEADOW AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-3205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 33 W GRAND AVE STE 500
Second Line :
City : CHICAGO
State : IL
Zip : 60654-6799
Country : US
Telephone Number : 800-325-1812
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : ZUL KAPADIA
Credential :
Telephone Number : 847-997-6774
Provider Enumeration Date : 05/04/2026
Last Update Date : 05/04/2026

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1588468102 — PERSEPHONE ROSS
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Directions to “PRISM FOUNDATION ” Practice Location

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