Provider Demographics
NPI:1891902359
Name:PARESI, ROBERT J JR (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:PARESI
Suffix:JR
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 1:3050 FINLEY RD
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1196
Mailing Address - Country:US
Mailing Address - Phone:331-777-9955
Mailing Address - Fax:331-777-9954
Practice Address - Street 1:3050 FINLEY RD
Practice Address - Street 2:SUITE 300B
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1196
Practice Address - Country:US
Practice Address - Phone:331-777-9955
Practice Address - Fax:331-777-9954
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4387392086S0122X
FLME980202086S0122X
WI557372086S0122X
IL0361132322086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1891902359Medicaid
WIP00965289DB7792OtherRAILROAD MEDICARE
WIPARESROBOtherMERCYCARE INSURANCE
WI1891902359Medicaid
WIPARESROBOtherMERCYCARE INSURANCE
WIP00965289DB7792OtherRAILROAD MEDICARE
WI1891902359Medicaid
FLAD976ZMedicare PIN
IL214660076Medicare PIN
WI1891902359Medicaid