Paris Givhan
Individual provider Active NPI Driver · Park Forest, IL
NPI 1235825829 · NPPES record last updated Apr 17, 2023
Key facts
- NPI
- 1235825829
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- G15066487622 (IL)
- Practice address
- 339 Winnebago St
Park Forest, IL 60466-1366 - Phone
- (708) 663-4331
- NPI assigned
- Apr 17, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G15066487622 | IL | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | G15066487622 | IL | Yes |
Addresses
Primary practice location
339 Winnebago St
Park Forest, IL 60466-1366
Mailing address
339 Winnebago St
Park Forest, IL 60466-1366
Phone (708) 663-4331
Other providers in Park Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.