# PRAIRIE STATE SPORTS MEDICINE CENTER, SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740324177
- **Authorized official:** DR. BRIAN BABKA MD (PRESIDENT)
- **Authorized official phone:** (630) 220-0625

## Contact information

- **Practice address:** 2900 FOXFIELD RD, ST CHARLES, IL 60174-5799
- **Practice address phone:** (630) 220-0625
- **Mailing address:** 1638 CHESTNUT HILL CT, SUGAR GROVE, IL 60554-9336

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | — | IL | Yes |

## Other

- **Enumeration date:** 02/18/2007
- **Last updated:** 08/22/2020