Individual
DR. PRASHANT JOLEPALEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 334-5566
(815) 759-4008
Mailing address
1001 AVENIDA PICO, STE C #156, SAN CLEMENTE, CA 92673-8198
(248) 762-0529
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
56922
AZ
207UN0902X
Nuclear Imaging & Therapy Physician
275316
NY
2085R0202X
Diagnostic Radiology Physician
Primary
036134688
IL
2085R0202X
Diagnostic Radiology Physician
275316
NY
2085R0202X
Diagnostic Radiology Physician
56922
AZ
2085R0202X
Diagnostic Radiology Physician
A169326
CA
390200000X
Student in an Organized Health Care Education/Training Program
4301096774
MI
Other
Enumeration date
07/08/2010
Last updated
12/06/2023
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