Basic Information
Provider Information
NPI: 1306824511
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIXIT
FirstName: PARESH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7808 W COLLEGE DR
Address2: SUITE 1 SE
City: PALOS HEIGHTS
State: IL
PostalCode: 604631027
CountryCode: US
TelephoneNumber: 7084486300
FaxNumber: 7084486350
Practice Location
Address1: 12251 S. 80TH AVE
Address2: PALOS COMMUNITY HOSPITAL
City: PALOS HEIGHTS
State: IL
PostalCode: 60463
CountryCode: US
TelephoneNumber: 7089234000
FaxNumber: 7084486350
Other Information
ProviderEnumerationDate: 01/06/2006
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X ILY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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