Enayatollah Rezvani, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Practice address

605 W Central Road
Suite 204
Arlington Heights, IL 60005-2364

Phone

(847) 259-2620

Fax

(847) 259-6409

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• E Rezvani MD SC

  • Pediatrics Physician
  • Arlington Heights, IL
  • NPI 1235228032
  NPD (past) Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679662472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 W CENTRAL ROAD",
            "address_2": "SUITE 204",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052364",
            "telephone_number": "847-259-2620",
            "fax_number": "847-259-6409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 W CENTRAL ROAD",
            "address_2": "SUITE 204",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052364",
            "telephone_number": "847-259-2620",
            "fax_number": "847-259-6409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZVANI",
        "first_name": "ENAYATOLLAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reymar Dental Clinic
• Reynolds-Incardona
• Reynolds-Incardona LTD.
• Aubrey Reynolds
• Harry R. Reynolds, DMD
• Casey Rhew, LCSW
• John Rhodes
• Lina Riaz, PA
• Krista Nicole Ribando, DC
• Rebecca Rice

• Pediatrics Physician in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.