IndividualActive
Prakash Jayabalan, M.D., PHD
NPI 1457648073 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Chicago, IL
Provider details
- NPI number
- 1457648073
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D., PHD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 036140895 (IL)
Specialties & taxonomies
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianPrimary2081S0010XLicense 036-140895 (IL)
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
355 E Erie St
Chicago, IL 60611-3167
Phone: (312) 238-1000
Approximate (ZIP-level) locationGet directions
Mailing address
355 E Erie St
Chicago, IL 60611-3167
Registry dates
- Enumerated
- 2011-07-03
- Last updated
- 2022-04-26
- Certified
- 2022-04-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.