Provider Demographics
NPI:1427612738
Name:PARNIA, SHANLI (MD)
Entity type:Individual
Prefix:DR
First Name:SHANLI
Middle Name:
Last Name:PARNIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MADISON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 MADISON ST STE 300
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-4210
Practice Address - Country:US
Practice Address - Phone:708-486-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2023-01-17
Deactivation Date:2019-12-09
Deactivation Code:
Reactivation Date:2019-12-18
Provider Licenses
StateLicense IDTaxonomies
IL036161791207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine