Provider Demographics
NPI:1922265818
Name:PARRA SANCHEZ, IVAN ADOLFO (MD)
Entity Type:Individual
Prefix:
First Name:IVAN
Middle Name:ADOLFO
Last Name:PARRA SANCHEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2400 N ROCKTON AVE
Mailing Address - Street 2:ANESTHESIOLOGY DEPT
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61103-3655
Mailing Address - Country:US
Mailing Address - Phone:815-971-4000
Mailing Address - Fax:815-971-9985
Practice Address - Street 1:2400 N ROCKTON AVE
Practice Address - Street 2:ANESTHESIOLOGY DEPT
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-3655
Practice Address - Country:US
Practice Address - Phone:815-971-4000
Practice Address - Fax:815-971-9985
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH57-011425207L00000X
IL036135954207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology