Provider Demographics
NPI:1114979036
Name:PARA, PATRICK FRANCIS (DO)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:FRANCIS
Last Name:PARA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1121 LAKE COOK RD
Mailing Address - Street 2:STE M
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-5234
Mailing Address - Country:US
Mailing Address - Phone:847-945-4550
Mailing Address - Fax:847-948-8103
Practice Address - Street 1:1416C S RANDALL RD
Practice Address - Street 2:RANDALL SQUARE SHOPPING CENTER
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4682
Practice Address - Country:US
Practice Address - Phone:630-208-9325
Practice Address - Fax:630-208-9326
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK07633Medicare ID - Type Unspecified
ILL61865Medicare ID - Type Unspecified
G39838Medicare UPIN