Provider Demographics
NPI:1659309151
Name:PARIKH, MAHESH N (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHESH
Middle Name:N
Last Name:PARIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 DAKOTA ST
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60012-3732
Mailing Address - Country:US
Mailing Address - Phone:815-455-1945
Mailing Address - Fax:815-455-1635
Practice Address - Street 1:615 DAKOTA ST
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60012-3732
Practice Address - Country:US
Practice Address - Phone:815-455-1945
Practice Address - Fax:815-455-1635
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL360681232084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5621190OtherBCBS
IL753240Medicare ID - Type Unspecified
IL5621190OtherBCBS