Organization
PRAKASH VAISHNAV MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRAKASH VAISHNAV MD (PRESIDENT)
(630) 952-1412
Entity
Organization
Contact information
Practice address
4 MARISSA CT, BURR RIDGE, IL 60527-6864
(630) 952-1412
Mailing address
4 MARISSA CT, BURR RIDGE, IL 60527-6864
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
10/15/2021
Last updated
08/25/2025
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