=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942308267
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHERMI V. PARIKH MEDICAL CORPORATION SC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2006
-----------------------------------------------------
Last Update Date | 04/01/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2454 E DEMPSTER ST
-----------------------------------------------------
City | DES PLAINES
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60016-5315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-788-3880
-----------------------------------------------------
Fax | 847-699-3288
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2454 E DEMPSTER ST
-----------------------------------------------------
City | DES PLAINES
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60016-5315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-788-3880
-----------------------------------------------------
Fax | 847-699-3288
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PODIATRIST
-----------------------------------------------------
Name | SHERMI PARIKH
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 773-818-6622
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0131X
-----------------------------------------------------
Taxonomy Name | Foot Surgery Podiatrist
-----------------------------------------------------
License Number | 016-004938
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------