Praveen V Parvathala MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRAVEEN V PARVATHALA MD LLC

Practice address

3555 Sweet Maggie LN
Naperville, IL 60564-8303

Phone

(630) 904-6210

Fax

(630) 952-1447

NPI assigned

May 5, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Praveen V Parvathala, M.D.

Title

President

Phone

(708) 691-0405

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255651200000",
    "number": "1336373356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 SWEET MAGGIE LN",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648303",
            "telephone_number": "630-904-6210",
            "fax_number": "630-952-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 SWEET MAGGIE LN",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648303",
            "telephone_number": "630-904-6210",
            "fax_number": "630-952-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAVEEN V PARVATHALA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-10-16",
        "status": "A",
        "authorized_official_last_name": "PARVATHALA",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-691-0405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.