Provider Demographics
NPI:1144209339
Name:NAAZ-IKRAMUDDIN, PARVEEN (MD)
Entity Type:Individual
Prefix:
First Name:PARVEEN
Middle Name:
Last Name:NAAZ-IKRAMUDDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PARVEEN
Other - Middle Name:
Other - Last Name:NAAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3401 CONIFER DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62711-8300
Mailing Address - Country:US
Mailing Address - Phone:630-469-2000
Mailing Address - Fax:
Practice Address - Street 1:3315 ALGONQUIN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-3257
Practice Address - Country:US
Practice Address - Phone:224-735-3486
Practice Address - Fax:224-764-3011
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036094415207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094415Medicaid
ILP00987820OtherRR MEDICARE PTAN
IL216019001Medicare PIN
IL036094415Medicaid