NPIMap

Individual provider Active NPI

Vikram C Prabhu, MD

  • Neurological Surgery Physician
  • Maywood, IL
National Provider Identifier
1124005004
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
36111189 Issued in IL
Practice address
2160 S 1St Ave
(Maguire Center, RM. 1900)
Maywood, IL 60153
Phone
(708) 216-8563
Fax
(708) 216-4948
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 36111189 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
(Maguire Center, RM. 1900)
Maywood, IL 60153

Mailing address

2160 S 1St Ave
(Maguire Center, RM. 1900)
Maywood, IL 60153
Phone (708) 216-8563

Other identifiers 1

IdentifierTypeStateIssuer
36111189MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040817000453 IL Practitioner - Neurosurgery 1850362617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Nebraska College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

17901 S la Grange Rd
Tinley Park, IL 60487-7226
Phone (708) 327-8300

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

6800 N Frontage Rd
Burr Ridge, IL 60527-7819
Phone (708) 327-1000

Hospital & facility affiliations

  • Loyola Medicine Home Care Home health agency, Oak Brook, IL, CCN 147257
  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
  • Loyola Gottlieb Memorial Hospital Hospital, Melrose Park, IL, CCN 140008
  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36111189ILMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Jan 1, 2009 Accepting new patients
Loyola University Medical Center CurrentSince Jan 1, 2009 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Loyola University Physician Foundation Past Accepting new patients

Locations

420 W Butterfield Rd
Elmhurst, IL 60126
Phone (630) 832-2300

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2160 S 1st Ave
Bldg 101
Maywood, IL 60153
Phone (708) 216-8785

2160 S 1st Ave
Rm 1900
Maywood, IL 60153
Phone (708) 216-8563

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

Interoperability endpoints

  • Direct secure messaging: vprabhu6315@direct.luhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1124005004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "(MAGUIRE CENTER, RM. 1900)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-8563",
            "fax_number": "708-216-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "(MAGUIRE CENTER, RM. 1900)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-8563",
            "fax_number": "708-216-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRABHU",
        "first_name": "VIKRAM",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "36111189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36111189",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.