Doctor Name: | MR. ANDREY I PARVANOV |
NPI Number: | 1740328921 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 070-011637 |
Business Practice Address: | 1720 Grand Ave Waukegan, IL - 600853502 |
Business Phone Number: | 8476250202 |
Business Fax Number: | 8476250101 |
Mailing Address: | 17779 W Salisbury Dr, GURNEE |
State: | IL |
Postal Code: | 600314598 |
Phone Number: | 8479128717 |
Fax Number: | 8478560712 |
NPI Enumeration Date: | 02/01/2007 |
NPI Last Update Date: | 08/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 070-011637 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |