Individual
SANJIV PRABHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036127597
IL
Other
Enumeration date
04/23/2008
Last updated
04/22/2013
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