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Organization
P. DE SILVA, M.D.., S.C.
Active
Organization
P. DE SILVA, M.D.., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PARAKRAMA DE SILVA M.D. (PRESIDENT, P. DE SILVA, M.D., S.C.)
(773) 585-4900
Entity
Organization
Contact information
Practice address
4248 W 63RD ST, CHICAGO, IL 60629-5037
(773) 585-4900
(773) 585-7262
Mailing address
4248 W 63RD ST, CHICAGO, IL 60629-5037
(773) 585-4900
(773) 585-7262
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036042344
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036042344
—
IL
01
—
062528037
(RAILROAD) MEDICARE
IL
01
—
21601914
BLUE CROSS/ BLUE SHIELD
IL
Enumeration date
04/20/2006
Last updated
08/03/2010
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