Provider Demographics
NPI:1831080167
Name:RIZWANI, PRACHI SHANKAR
Entity type:Individual
Prefix:
First Name:PRACHI SHANKAR
Middle Name:
Last Name:RIZWANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 NW 54TH ST APT 512
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3868
Mailing Address - Country:US
Mailing Address - Phone:424-402-7706
Mailing Address - Fax:
Practice Address - Street 1:4849 W BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-4330
Practice Address - Country:US
Practice Address - Phone:773-798-9938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program