Provider Demographics
NPI:1376234112
Name:MAPLE HEALTH PRIMARY CARE PLLC
Entity Type:Organization
Organization Name:MAPLE HEALTH PRIMARY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ISHVARI
Authorized Official - Middle Name:S
Authorized Official - Last Name:PANARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:224-717-5182
Mailing Address - Street 1:240 W PRESTWICK ST
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4232
Mailing Address - Country:US
Mailing Address - Phone:224-717-5182
Mailing Address - Fax:224-517-3192
Practice Address - Street 1:800 E WOODFIELD RD STE 103
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4718
Practice Address - Country:US
Practice Address - Phone:224-717-5182
Practice Address - Fax:224-517-3192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty