Healthcare Provider Details

I. General information

NPI: 1649420605
Provider Name (Legal Business Name): TRUPTI R PARIKH CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 W 95TH ST SUITE 1332H
OAK LAWN IL
60453-2600
US

IV. Provider business mailing address

4440 W 95TH ST SUITE 1332H
OAK LAWN IL
60453-2600
US

V. Phone/Fax

Practice location:
  • Phone: 708-684-2016
  • Fax: 708-684-4808
Mailing address:
  • Phone: 708-684-2016
  • Fax: 708-684-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209-005085
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: