Individual
DR. RAVI K PRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 N HIGHLAND AVE, AURORA, IL 60506-1404
(630) 859-8700
Mailing address
28594 NETWORK PL, CHICAGO, IL 60673-1285
(630) 859-6800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.014359
OH
207RG0100X
Gastroenterology Physician
Primary
036.138013
IL
207RG0100X
Gastroenterology Physician
ME118395
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012210500
—
FL
Enumeration date
07/16/2008
Last updated
10/25/2022
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