MEDICARE: DR. JOHN V PRUNSKIS MD

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	208VP0014X	Interventional Pain Medicine Physician	36066854	IL

General Provider Information

NPI Number	:	1962416370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN V PRUNSKIS MD

Provider Business Mailing Address
First Line	:	431 SUMMIT ST
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60120-3805
Country	:	US
Telephone Number	:	847-289-8822
Fax Number	:	847-289-0815

Provider Business Practice Location Address
First Line	:	431 SUMMIT ST
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60120
Country	:	US
Telephone Number	:	847-289-8822
Fax Number	:	847-289-0815

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	04/16/2026

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