Provider Demographics
NPI:1316946890
Name:JOSHI, PRASHANT KUMAR (MD)
Entity type:Individual
Prefix:
First Name:PRASHANT
Middle Name:KUMAR
Last Name:JOSHI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1250
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:4440 W 95TH ST FL 8
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:708-684-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099563207RH0003X, 174400000X
IL036-099563207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL363980044OtherTAX ID#
IL363387138OtherTAX IDENTIFICATION NUMBER
IL632020Medicare PIN
IL363980044OtherTAX ID#
ILH35714Medicare UPIN
IL355030008Medicare PIN
IL363387138OtherTAX IDENTIFICATION NUMBER
ILP00916476Medicare PIN
IL355031Medicare PIN
IL703500Medicare ID - Type Unspecified
IL632020008Medicare PIN
IL355030Medicare PIN