Healthcare Provider Details

I. General information

NPI: 1144209339
Provider Name (Legal Business Name): PARVEEN NAAZ-IKRAMUDDIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PARVEEN NAAZ M.D.

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 FRANKLIN AVE STE 3000
NORMAL IL
61761
US

IV. Provider business mailing address

420 NE GLEN OAK AVE, STE 401
PEORIA IL
61603
US

V. Phone/Fax

Practice location:
  • Phone: 309-676-8123
  • Fax: 309-676-8455
Mailing address:
  • Phone: 309-676-8123
  • Fax: 309-676-8455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number036094415
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: