Individual provider Active NPI

Mahyar Parvin, M.D.

  • Psychiatry Physician
  • Plainfield, IL
National Provider Identifier
1730395054
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036111592 Issued in IL
Practice address
24821 W 135TH St
Plainfield, IL 60544-5413
Phone
(815) 254-7400
Fax
(815) 254-7408
NPI assigned
May 15, 2007
Last updated
Feb 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036111592 IL Primary

Addresses

Primary practice location

24821 W 135TH St
Plainfield, IL 60544-5413

Mailing address

13400 S Route 59 Unit 116
Box 245
Plainfield, IL 60585-5830
Phone (815) 254-7400

Other identifiers 1

IdentifierTypeStateIssuer
036111592 1MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036111592ILMDPsychiatry Physician

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1730395054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 S ROUTE 59 UNIT 116",
            "address_2": "BOX 245",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605855830",
            "telephone_number": "815-254-7400",
            "fax_number": "815-254-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24821 W 135TH ST",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605445413",
            "telephone_number": "815-254-7400",
            "fax_number": "815-254-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARVIN",
        "first_name": "MAHYAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036111592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111592 1",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.