Provider Demographics
NPI:1912292582
Name:PAREIGIS, ELIZABETH RUTA (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:RUTA
Last Name:PAREIGIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 JOHN DEERE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6812
Mailing Address - Country:US
Mailing Address - Phone:309-779-4225
Mailing Address - Fax:309-779-4305
Practice Address - Street 1:600 JOHN DEERE RD STE 200
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6812
Practice Address - Country:US
Practice Address - Phone:309-779-4225
Practice Address - Fax:309-779-4305
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-12
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036135132207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036135132Medicaid
ILF400154005Medicare PIN