Selvaraj, Prakash

Selvaraj, Prakash is an individual health care provider with primary practice located at 396 Remington Blvd Suite 340, Bolingbrook IL 60440-1732. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Selvaraj, Prakash can be contacted via phone (630) 759-9800.

Contact Information

Primary practice address
396 Remington Blvd Suite 340 Bolingbrook IL 60440-1732
Phone: (630) 759-9800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036-095872 Illinois

Profile Details

NPI number 1467454124
LBN Legal business name Selvaraj, Prakash
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Oct 4th, 2011 - about 15 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 1467454124 NPPES
Illinois MEDICAID 036-095872-1

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