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Individual
DR. MICHAEL PRENDERGAST
Active
Individual
DR. MICHAEL PRENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
NULL
208600000X
Surgery Physician
036091607
IL
2086S0129X
Vascular Surgery Physician
Primary
036091607
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091607
—
IL
Enumeration date
08/25/2006
Last updated
01/08/2021
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