Individual provider Active NPI

Andrey I Parvanov, P.T.

  • Physical Therapist
  • Elk Grove Village, IL
National Provider Identifier
1740328921
Registry record updated Dec 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070-011637 Issued in IL
Practice address
47 Sylvan CT
Elk Grove Village, IL 60007
Phone
(312) 898-8085
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-011637 IL Primary

Addresses

Primary practice location

47 Sylvan CT
Elk Grove Village, IL 60007

Mailing address

47 Sylvan CT
Elk Grove Village, IL 60007-3565
Phone (312) 898-8085

Other practice location 1

47 Sylvan Ct
Elk Grove Village, IL 60007
Phone (312) 898-8085

Other practice location 2

1720 Grand Ave
Waukegan, IL 60085-3502
Phone (847) 625-0202 ext. 16

Other identifiers 1

IdentifierTypeStateIssuer
3049325227OtherILBCBS

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

State licenses

LicenseStateTypeSpecialty
070-011637ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545523200000",
    "number": "1740328921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 SYLVAN CT",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073565",
            "telephone_number": "312-898-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 SYLVAN CT",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "60007",
            "telephone_number": "312-898-8085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 Sylvan Ct",
            "address_purpose": "LOCATION",
            "city": "Elk Grove Village",
            "state": "IL",
            "postal_code": "60007",
            "country_code": "US",
            "telephone_number": "312-898-8085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1720 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Waukegan",
            "state": "IL",
            "postal_code": "600853502",
            "country_code": "US",
            "telephone_number": "847-625-0202 x16",
            "fax_number": "847-625-0101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARVANOV",
        "first_name": "ANDREY",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2018-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-011637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3049325227",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2018; 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.