Provider Demographics
NPI:1225064686
Name:PITRODA, PAROL P (MD)
Entity Type:Individual
Prefix:
First Name:PAROL
Middle Name:P
Last Name:PITRODA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAROL
Other - Middle Name:
Other - Last Name:REGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 959134
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-9134
Mailing Address - Country:US
Mailing Address - Phone:224-353-6361
Mailing Address - Fax:847-278-5398
Practice Address - Street 1:19 E SCHAUMBURG RD FL 2
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-3503
Practice Address - Country:US
Practice Address - Phone:224-353-6361
Practice Address - Fax:847-278-5398
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036115162202K00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036115162Medicaid
ILIL3712001Medicare PIN
IL61604001Medicare PIN
IL036115162Medicaid