Basic Information
| Provider Information | |||||||||
| NPI: | 1386800902 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARRELLA | ||||||||
| FirstName: | NAOMI | ||||||||
| MiddleName: | I | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ISHIBASHI | ||||||||
| OtherFirstName: | NAOMI | ||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3333 GREEN BAY RD | ||||||||
| Address2: | DEPARTMENT OF FAMILY & PREVENTIVE MEDICINE | ||||||||
| City: | NORTH CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600643037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475783338 | ||||||||
| FaxNumber: | 8475788569 | ||||||||
| Practice Location | |||||||||
| Address1: | 431 LAKEVIEW CT | ||||||||
| Address2: | SUITE D | ||||||||
| City: | MOUNT PROSPECT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472963040 | ||||||||
| FaxNumber: | 8472965546 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2008 | ||||||||
| LastUpdateDate: | 05/15/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036.123845 | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.