Active NPI
Mahyar Parvin, M.D.
- Psychiatry Physician
- Plainfield, IL
National Provider Identifier
1730395054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036111592
- 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, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036111592 1 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 036111592 | IL | MD | Psychiatry 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.