Selvaraj, Prakash
Selvaraj, Prakash is an individual health care provider with primary practice located at 396 Remington Blvd Suite 340, Bolingbrook IL 60440-1732. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Selvaraj, Prakash can be contacted via phone (630) 759-9800.Contact Information
Primary practice address
396 Remington Blvd Suite 340
Bolingbrook IL 60440-1732
Phone: (630) 759-9800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 036-095872 | Illinois |
Profile Details
| NPI number | 1467454124 |
|---|---|
| LBN Legal business name | Selvaraj, Prakash |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 12th, 2005 |
| Last updated | Oct 4th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467454124 | NPPES |
| Illinois | MEDICAID | 036-095872-1 |
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