Provider Demographics
NPI:1821060468
Name:PAPARELLA, DOMINICK (DO)
Entity Type:Individual
Prefix:DR
First Name:DOMINICK
Middle Name:
Last Name:PAPARELLA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 FURLONG DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3701
Mailing Address - Country:US
Mailing Address - Phone:847-918-7648
Mailing Address - Fax:847-918-7648
Practice Address - Street 1:DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER
Practice Address - Street 2:3001 GREEN BAY ROAD
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064
Practice Address - Country:US
Practice Address - Phone:224-610-3754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery