Physician Compare National (NPI:1245256965)

HEALTHCARE PROVIDER: PARAG THAKKAR MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1245256965
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183753106
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100528000548
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	THAKKAR
	Individual professional last name
Provider First Name	PARAG
	Individual professional first name
Provider Middle Name	B
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1170 E BELVIDERE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 210
	Group Practice or individual's line 2 address
City	GRAYSLAKE
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	600302034
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140202
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADVOCATE CONDELL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140130
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NORTHWESTERN LAKE FOREST HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y