1942336755 NPI number — PARIKH & ABBASI MDSC

Table of content: (NPI 1942336755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942336755 NPI number — PARIKH & ABBASI MDSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARIKH & ABBASI MDSC
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:
Provider Other Organization Name Type Code:
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:
1942336755
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17680 S. KEDZIE AVE
Provider Second Line Business Mailing Address:
SUITE 206
Provider Business Mailing Address City Name:
HAZEL CREST
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-206-0190
Provider Business Mailing Address Fax Number:
708-310-4327

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17680 KEDZIE AVE
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
HAZEL CREST
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60429-2043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-206-0190
Provider Business Practice Location Address Fax Number:
708-310-4327
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PARIKH
Authorized Official First Name:
DILIP
Authorized Official Middle Name:
Authorized Official Title or Position:
CO PRESIDENT
Authorized Official Telephone Number:
708-206-1090

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  042 006610 , 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: 0001618484 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 036068401 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: CA8400 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 036057523 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 036077608 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".




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