# LM PRASAD M.D S.C

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

## Provider details

- **NPI number:** 1740360106
- **Authorized official:** DR. LEELA M PRASAD M.D. (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (847) 759-1110

## Contact information

- **Practice address:** 1550 N NORTHWEST HWY, 107, PARK RIDGE, IL 60068-1411
- **Practice address phone:** (847) 759-1110
- **Practice address fax:** (847) 759-8273
- **Mailing address:** 1550 N NORTHWEST HWY, 107, PARK RIDGE, IL 60068-1411
- **Mailing address phone:** (847) 759-1110
- **Mailing address fax:** (847) 759-8273

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | Yes |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 10/09/2007