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DR. PRAKASH SIDHA JAYABALAN M.D. PHD NPI 1457648073


NPI Information

NPI: 1457648073
Provider Name: DR. PRAKASH SIDHA JAYABALAN, M.D., PHD
Classification: Physical Medicine & Rehabilitation - 2081S0010X
Entity Type: Individual

Specialization: Sports Medicine

Organization: MEDICAL SERVICES RIC

PECOS Registration: Yes

Address:
355 E ERIE ST
CHICAGO, IL
ZIP 60611
Phone: (312) 238-1000
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DR. Prakash Sidha Jayabalan, M.D., PHD is a sports medicine physical medicine rehabilitation in Chicago, IL with 20 years of experience. The provider is a physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. DR. Prakash Sidha Jayabalan, M.D., PHD NPI is 1457648073. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

355 E ERIE ST
CHICAGO, IL
ZIP 60611-167
Phone: (312) 238-1000

The NPI 1457648073 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/3/2011 and was last updated on 12/4/2017.


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
1208100000XPhysical Medicine & Rehabilitation036140895ILLINOISNo
22081S0010XPhysical Medicine & RehabilitationSports Medicine036-140895ILLINOISYes

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
1036140895-1MEDICAIDILLINOIS

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.