Individual
DR. PRABHU MANI VELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2320 E 93RD ST, CHICAGO, IL 60617-3909
(773) 967-5404
(773) 967-3954
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(847) 390-4757
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
036110136
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618831
BCBS PROVIDER NUMBER
IL
05
—
036110136
—
IL
01
—
P00425691
RR MEDICARE PROVIDER NUMBER
IL
Enumeration date
08/17/2006
Last updated
03/05/2026
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