Provider Demographics
NPI:1336324417
Name:PRAZAD, PREETHA AMBIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:PREETHA
Middle Name:AMBIKA
Last Name:PRAZAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PREETHA
Other - Middle Name:AMBIKA
Other - Last Name:THANUMALAYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1410 WINSTON DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6833
Mailing Address - Country:US
Mailing Address - Phone:847-824-9234
Mailing Address - Fax:
Practice Address - Street 1:1775 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1143
Practice Address - Country:US
Practice Address - Phone:847-723-5313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361118712080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine