Individual
SANJAY PRASAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1253 N ALPINE RD, ROCKFORD, IL 61107-2201
(779) 696-9201
(815) 397-9667
Mailing address
10215 FERNWOOD RD, SUITE 301, BETHESDA, MD 20817-1106
(301) 493-9409
(301) 493-9429
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036176815
IL
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
036176815
IL
207YX0901X
Otology & Neurotology Physician
D43688
MD
Other
Enumeration date
10/24/2006
Last updated
03/23/2026
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