Provider Demographics
NPI: | 1053587154 |
---|---|
Name: | YOGESH B PARIKH MD SC |
Entity type: | Organization |
Organization Name: | YOGESH B PARIKH MD SC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | YOGESH |
Authorized Official - Middle Name: | B |
Authorized Official - Last Name: | PARIKH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 847-673-5469 |
Mailing Address - Street 1: | 7111 N HAMLIN |
Mailing Address - Street 2: | |
Mailing Address - City: | LINCOLNWOOD |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60712 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 847-673-5469 |
Mailing Address - Fax: | 847-673-5469 |
Practice Address - Street 1: | 7111 N HAMLIN |
Practice Address - Street 2: | |
Practice Address - City: | LINCOLNWOOD |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60712 |
Practice Address - Country: | US |
Practice Address - Phone: | 847-673-5469 |
Practice Address - Fax: | 847-673-5469 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-05-08 |
Last Update Date: | 2011-01-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
IL | 036057966 | Medicaid |