Dr. Prakash Sidha Jayabalan
Physical Medicine & Rehabilitation Doctor Sports Medicine
355 E Erie St
Chicago
, Illinois 60611-3167
Dr. Prakash Sidha Jayabalan
Physical Medicine & Rehabilitation Doctor Sports Medicine
355 E Erie St
Chicago
, Illinois 60611-3167
(312) 238-1000
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About
Features
Specialties
- Physical Medicine & Rehabilitation Doctor
- Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Prakash Sidha Jayabalan
- 355 E Erie St
- Chicago, IL
- Zip : 60611-3167
- Phone : (312) 238-1000
Second Address
- Dr. Prakash Sidha Jayabalan
- 355 E Erie St
- Chicago, IL
- Zip : 60611-3167
- Phone : (312) 238-1000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation Doctor | 036140895 | IL |
| Y | 2081S0010X | Sports Medicine | 036-140895 | IL |
| Y | 213ES0000X | Sports Medicine | 036-140895 | IL |
National Provider Identifier
| NPI | 1457648073 |
|---|---|
| Provider Name | Dr. Prakash Sidha Jayabalan |
| First Address | Chicago, IL 60611-3167 |
| Second Address | Chicago, IL 60611-3167 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/07/2011 |
| Last Update Date | 04/12/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036140895-1 | (05) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.