1942308267 NPI number — SHERMI V. PARIKH MEDICAL CORPORATION SC

Table of content: (NPI 1942308267)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942308267 NPI number — SHERMI V. PARIKH MEDICAL CORPORATION SC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHERMI V. PARIKH MEDICAL CORPORATION SC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FAMILY FOOT AND ANKLE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942308267
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2454 E DEMPSTER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DES PLAINES
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60016-5315
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-788-3880
Provider Business Mailing Address Fax Number:
847-699-3288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2454 E DEMPSTER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DES PLAINES
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60016-5315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-788-3880
Provider Business Practice Location Address Fax Number:
847-699-3288
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PARIKH
Authorized Official First Name:
SHERMI
Authorized Official Middle Name:
Authorized Official Title or Position:
PODIATRIST
Authorized Official Telephone Number:
773-818-6622

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X , with the licence number:  016-004938 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0001638530 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 1114914884 . This is a "NPI NUMBER" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: P00118678 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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