Individual provider Active NPI

Mary Kathryn Prahl, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1114161809
Registry record updated Sep 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036130474 Issued in IL
Practice address
225 E Chicago Ave
Chicago, IL 60611-2991
Phone
(312) 227-4000
NPI assigned
Apr 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036130474 IL Primary

Addresses

Primary practice location

225 E Chicago Ave
Chicago, IL 60611-2991

Mailing address

225 E Chicago Ave
Chicago, IL 60611-2991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160831000160 CA Practitioner - Pediatric Medicine 3971895723 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036130474ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Jul 1, 2016 Accepting new patients
University of California San Francisco Pediatrics Current Accepting new patients
University of California San Francisco CurrentSince Jul 1, 2016 Accepting new patients
University of California San Francisco Pediatrics CurrentSince Jul 1, 2016 Accepting new patients
UCSF Pediatrics Associates Pediatrics CurrentSince Jul 1, 2016 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 1, 2016 Accepting new patients
University of California San Francisco Medical Center Past Accepting new patients

Locations

1825 4th St
Fl 6
San Francisco, CA 94143
Phone (415) 353-7337

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348963200000",
    "number": "1114161809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAHL",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-24",
        "last_updated": "2012-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036130474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.