Individual
VIKRAM C PRABHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, (MAGUIRE CENTER, RM. 1900), MAYWOOD, IL 60153
(708) 216-8563
(708) 216-4948
Mailing address
2160 S 1ST AVE, (MAGUIRE CENTER, RM. 1900), MAYWOOD, IL 60153
(708) 216-8563
(708) 216-4948
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
36111189
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36111189
—
IL
Enumeration date
12/30/2005
Last updated
03/04/2010
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