Koneru, Prafulla K

Koneru, Prafulla K is an sole proprietor health care provider with primary practice located at 5 Executive Court Suite 1, South Barrington IL 60010. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. Koneru, Prafulla K can be contacted via phone (847) 382-8200.

Contact Information

Primary practice address
5 Executive Court Suite 1 South Barrington IL 60010
Phone: (847) 382-8200
Fax: (847) 382-8210
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 036052132 Illinois
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036052132 Illinois

Profile Details

NPI number 1093700072
LBN Legal business name Koneru, Prafulla K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 15th, 2005
Last updated Oct 7th, 2011 - about 14 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 1093700072 NPPES
Illinois MEDICAID 036052132

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