Provider Demographics
NPI:1326663022
Name:PRISM HOLISTIC CARE LTD
Entity Type:Organization
Organization Name:PRISM HOLISTIC CARE LTD
Other - Org Name:PRISM HOLISTIC CARE LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHBUB
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPADIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-391-9184
Mailing Address - Street 1:6505 N LONGMEADOW AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3205
Mailing Address - Country:US
Mailing Address - Phone:773-391-9184
Mailing Address - Fax:773-920-3322
Practice Address - Street 1:825 E SCHAUMBURG RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-3654
Practice Address - Country:US
Practice Address - Phone:800-325-1812
Practice Address - Fax:773-920-3322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty