Provider Demographics
NPI:1073780003
Name:PRABHAKAR J. PARIKH, M.D.P.C
Entity Type:Organization
Organization Name:PRABHAKAR J. PARIKH, M.D.P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRABHAKAR
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-923-8432
Mailing Address - Street 1:1542 MELBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-3119
Mailing Address - Country:US
Mailing Address - Phone:219-923-8432
Mailing Address - Fax:219-923-8432
Practice Address - Street 1:1851 SIBLEY BLVD
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-2252
Practice Address - Country:US
Practice Address - Phone:708-868-2300
Practice Address - Fax:708-868-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-094269261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094269Medicaid
ILG25973Medicare UPIN
IL036094269Medicaid
IN177570Medicare PIN