Prendergast, Michael

Prendergast, Michael is an individual health care provider with primary practice located at 800 Austin St Ste 207 , Evanston IL 60202-3442. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Prendergast, Michael can be contacted via phone (773) 326-2244.

Contact Information

Primary practice address
800 Austin St Ste 207 Evanston IL 60202-3442
Phone: (773) 326-2244
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Allopathic & Osteopathic Physicians / Surgery 208600000X 036091607 Illinois
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 036091607 Illinois

Profile Details

NPI number 1568570158
LBN Legal business name Prendergast, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2006
Last updated Jan 8th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568570158 NPPES
Illinois MEDICAID 036091607

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