SRIDHAR PRASAD


Address: 500 John Deere Road, Trinity 7th Street, Moline, IL 61265
Phone: 3097795923

SRIDHAR PRASAD (NPI# 1477611325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477611325
Entity Type Individual
Full Name SRIDHAR PRASAD
Credential MD
Practice Address 500 John Deere Road
Trinity 7th Street
Moline
IL 61265
Mailing Address 555 Valley View Drive
Moline
IL 61265
Practice Telephone 3097795923
Mailing Telephone 3097437326
Mailing Fax Number 3097657999
Enumeration Date 2006-12-04
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2080N0001X Pediatrics
Specialization: Neonatal-Perinatal Medicine
28327 IA Allopathic & Osteopathic Physicians
Y 2080N0001X Pediatrics
Specialization: Neonatal-Perinatal Medicine
IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IA 3076513 05

Other Providers SRIDHAR PRASAD

NPI Name Taxonomy Address Enumeration
1811045412 Sridhar Kasinadhuni Prasad Internal Medicine 10724 Wilshire Blvd, Apt 510, Los Angeles, CA 90024-4447 2007-01-08

Office Location

Street Address 500 JOHN DEERE ROAD
TRINITY 7TH STREET
City MOLINE
State IL
Zip Code 61265

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1326567199 Elizabeth Ann Teichler Respiratory Therapist, Registered 4360 7th Street, Moline, IL 61265 2017-09-13
1497279913 Caroline M Mather Behavioral Analyst 2430 6th Avenue, Moline, IL 61265 2017-07-26
1639625239 Elizabeth Anderson Nurse's Aide 4319 26th Ave Apt 1, Moline, IL 61265 2016-09-01
1437604154 Lindsey Bollaert Nurse Practitioner 1100 36th Ave, Moline, IL 61265 2016-08-23
1437541869 Divvymed, LLC Pharmacy 4300 44th Ave, Moline, IL 61265 2015-02-23
1477955250 Todd Stone Nurse Practitioner 1100 3th Avenue, Moline, IL 61265 2014-09-23
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Taxonomy Information

Taxonomy Code 2080N0001X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Neonatal-Perinatal Medicine

Taxonomy Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1487624839 Arled Izquierdo Pediatrics 500 John Deere Rd, Moline, IL 61265 2006-01-26

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1043767841 Gail Sharon Haiken Pediatrics 5303 Regents Park Rd, Rockford, IL 61107-5092 2016-09-08
1871910976 Jessica Lahn Chiang Pediatrics 1775 Dempster St # 54, Park Ridge, IL 60068-1143 2014-03-26
1669806667 Ricardo Tomas Rosenkranz Pediatrics 1200 N Lake Shore Dr, Apt. 904, Chicago, IL 60610-2370 2013-08-26
1063845626 Kala Sukerkar Pediatrics 2406 Indian Ridge Dr, Glenview, IL 60026-1030 2013-08-18
1407194780 Well Baby Care PC Pediatrics 1185-87 Dundee Avenue, Suite A-2, Elgin, IL 60120 2013-01-22
1275898116 Pele Boutrous Dina Pediatrics 415 N 9th St # 4w16, Springfield, IL 62702 2012-07-06
1447516257 John Vincent Hartline Pediatrics 1259 Prestwick Ln, Itasca, IL 60143-1975 2012-04-05
1780979302 Kelly Nelson Kelly Pediatrics 5841 S Maryland Ave # Mc6060, Chicago, IL 60637-1447 2011-06-11
1255623997 Venkata Sasidhar Majjiga Pediatrics 301 N 8th Street, Siu School of Medicine, Pediatrics, Room 3a169, Springfield, IL 62794 2011-05-13
1700187531 Ursula Patricia Colareta Ugarte Pediatrics 1444 Carol St Apt A, Park Ridge, IL 60068-1290 2010-11-10
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Competitor

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City MOLINE
Zip Code 61265

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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