Healthcare Provider Details

I. General information

NPI: 1013082551
Provider Name (Legal Business Name): PARVEEN K VARMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W 2ND ST
ROCK FALLS IL
61071-1005
US

IV. Provider business mailing address

425 E US ROUTE 6 SUITE A
MORRIS IL
60450-9042
US

V. Phone/Fax

Practice location:
  • Phone: 815-626-2230
  • Fax:
Mailing address:
  • Phone: 815-942-6511
  • Fax: 815-942-6582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036078826
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number036-078826
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: