Doctor Name: | DR. PRAFULLA K KONERU |
NPI Number: | 1093700072 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D |
License Number: | 036052132 |
Business Practice Address: | 5 Executive Court Suite 1 South Barrington, IL - 60010 |
Business Phone Number: | 8473828200 |
Business Fax Number: | 8473828210 |
Mailing Address: | 5 Executive Court, Suite 1 SOUTH BARRINGTON |
State: | IL |
Postal Code: | 60010 |
Phone Number: | 8473828200 |
Fax Number: | 8473828210 |
NPI Enumeration Date: | 09/15/2005 |
NPI Last Update Date: | 10/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 036052132 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |