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Contact Information

PRAKASH PEDAPATI
3535 N BELL SCHOOL RD
ROCKFORD, IL61114
 Phone: 779-696-9400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

NPI Profile & details for PRAKASH PEDAPATI · (Male)

NPI # 1295753259
Status Active
Credentials
Entity Individual
Enumeration date 07/18/2006
Last updated 02/22/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036058366
  • IL Medicaid 036058366
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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