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PRISM MEDICAL CENTER OF IL NFP NPI 1023101086


NPI Information

NPI: 1023101086
Provider Name: PRISM MEDICAL CENTER OF IL NFP
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 14D2010379

Address:
6346 N TALMAN AVE
STE # 102
CHICAGO, IL
ZIP 60659
Phone: (773) 262-1300
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PRISM MEDICAL CENTER OF IL NFP is an internal medicine in Chicago, IL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PRISM MEDICAL CENTER OF IL NFP NPI is 1023101086. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6346 N TALMAN AVE
STE # 102
CHICAGO, IL
ZIP 60659-898
Phone: (773) 262-1300
Fax: (773) 262-1184

The provider's authorized official is Mohammad A Saudye .
The authorized official title is Medical Director and has the following contact phone number (773) 262-1300.

The CLIA number assigned to this NPI record is 14D2010379 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineILLINOISYes
2207R00000XInternal MedicineILLINOISX
3207RI0011XInternal MedicineInterventional CardiologyILLINOISX
4208000000XPediatricsILLINOISX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
101633175OTHERILLINOISBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.