Healthcare Provider Details

I. General information

NPI: 1780620690
Provider Name (Legal Business Name): KRISHNA D PARAMESWAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2355 ROYAL BLVD
ELGIN IL
60123-4716
US

IV. Provider business mailing address

1412 NEVIS DR
NAPERVILLE IL
60565-1617
US

V. Phone/Fax

Practice location:
  • Phone: 872-231-3162
  • Fax:
Mailing address:
  • Phone: 708-542-8997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number036113897
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: