| Prism Direct Lab | |
|
33 W Grand Ave Ste 500 Chicago IL 60654-6799 | |
| (800) 325-1812 | |
| Not Available |
| Full Name | Prism Direct Lab |
|---|---|
| Speciality | Internal Medicine |
| Location | 33 W Grand Ave Ste 500, Chicago, Illinois |
| Authorized Official Name and Position | Mehbub Kapadia (DIRECTOR) |
| Authorized Official Contact | 7733919184 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prism Direct Lab 6505 N Longmeadow Ave Lincolnwood IL 60712-3205 Ph: (773) 391-9184 | Prism Direct Lab 33 W Grand Ave Ste 500 Chicago IL 60654-6799 Ph: (800) 325-1812 |
| NPI Number | 1326663022 |
|---|---|
| Provider Enumeration Date | 06/09/2020 |
| Last Update Date | 09/05/2025 |
| Certification Date | 09/05/2025 |
| Medicare PECOS PAC ID | 9931510708 |
|---|---|
| Medicare Enrollment ID | O20201130001546 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326663022 | NPI | - | NPPES |
| Provider Name | Mehbub S Kapadia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558584391 PECOS PAC ID: 4587715453 Enrollment ID: I20090706000636 |
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