Individual
DENNIS W PROHASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. O.
Contact information
Practice address
1516 S WABASH AVE, APT 1104, CHICAGO, IL 60605-2903
(414) 870-5178
Mailing address
1516 S WABASH AVE, APT 1104, CHICAGO, IL 60605-2903
(414) 870-5178
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
085-002276
IL
2085R0202X
Diagnostic Radiology Physician
Primary
02004880B
IN
363A00000X
Physician Assistant
085-002276
IL
363A00000X
Physician Assistant
1610-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41994500
—
WI
Enumeration date
12/28/2005
Last updated
07/15/2016
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