Provider Demographics
NPI:1386800902
Name:PARRELLA, NAOMI I (MD)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:I
Last Name:PARRELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:ISHIBASHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3333 GREEN BAY RD
Mailing Address - Street 2:DEPARTMENT OF FAMILY & PREVENTIVE MEDICINE
Mailing Address - City:NORTH CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60064-3037
Mailing Address - Country:US
Mailing Address - Phone:847-578-3338
Mailing Address - Fax:847-578-8569
Practice Address - Street 1:431 LAKEVIEW CT
Practice Address - Street 2:SUITE D
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056
Practice Address - Country:US
Practice Address - Phone:847-296-3040
Practice Address - Fax:847-296-5546
Is Sole Proprietor?:No
Enumeration Date:2008-08-03
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.123845207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine