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NPI Code Detail

MEDICARE: CHARLES W PARRISH III MD

MEDICARE:   CHARLES W PARRISH III MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice PhysicianIL

General Provider Information

NPI Number : 1982655437
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES W PARRISH III MD
Provider Business Mailing Address
First Line : 3601 W 183RD ST
Second Line :
City : HAZEL CREST
State : IL
Zip : 60429-2409
Country : US
Telephone Number : 708-957-7623
Fax Number : 708-957-7948
Provider Business Practice Location Address
First Line : 8012 S CRANDON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60617-1124
Country : US
Telephone Number : 773-768-6066
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 07/08/2007

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Directions to “ CHARLES W PARRISH III MD” Practice Location

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