Healthcare Provider Details

I. General information

NPI: 1710009923
Provider Name (Legal Business Name): SHEKOFEH PARSAEI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 01/28/2024
Certification Date: 01/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W HARRISON ST
CHICAGO IL
60612-3714
US

IV. Provider business mailing address

405 FOX TRAIL LN
OAK BROOK IL
60523-2784
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-1903
  • Fax:
Mailing address:
  • Phone: 630-590-5075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number036087462
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036-087462
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036-087462
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: