Jayabalan, Prakash Sidha

Jayabalan, Prakash Sidha is an sole proprietor health care provider with primary practice located at 355 E Erie St , Chicago IL 60611-3167. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Jayabalan, Prakash Sidha can be contacted via phone (312) 238-1000.

Contact Information

Primary practice address
355 E Erie St Chicago IL 60611-3167
Phone: (312) 238-1000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 036140895 Illinois
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X 036-140895 Illinois

Profile Details

NPI number 1457648073
LBN Legal business name Jayabalan, Prakash Sidha
Credentials M.D., PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 3rd, 2011
Last updated Apr 26th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457648073 NPPES
Illinois MEDICAID 036140895-1

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