Healthcare Provider Details

I. General information

NPI: 1295140291
Provider Name (Legal Business Name): PARISA GERAMI-LEHNERER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2014
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2210 DEAN ST STE M
ST CHARLES IL
60175-1059
US

IV. Provider business mailing address

2210 DEAN ST STE M
ST CHARLES IL
60175-1059
US

V. Phone/Fax

Practice location:
  • Phone: 630-593-1805
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number036.142238
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.065803
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: