Provider Demographics
NPI:1043313000
Name:PARVAIZ, AKHTAR (MD)
Entity Type:Individual
Prefix:DR
First Name:AKHTAR
Middle Name:
Last Name:PARVAIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 KRAML DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-0302
Mailing Address - Country:US
Mailing Address - Phone:630-546-1706
Mailing Address - Fax:630-887-9625
Practice Address - Street 1:2315 E 93RD ST
Practice Address - Street 2:SUITE 237
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-3936
Practice Address - Country:US
Practice Address - Phone:773-734-9200
Practice Address - Fax:773-734-9201
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048363A207RI0011X
IL036087645207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200393630Medicaid
IL036087645Medicaid
IL211467Medicare PIN
F59839Medicare UPIN
IL036087645Medicaid