Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Avni Dervishi

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1265010045

Avni Dervishi is a Student in an Organized Health Care Education/Training Program in Park Ridge, Illinois. Licensed in Illinois. Registered with an NPI since 2021.

Licensed in
IL
In the registry since
2021
Specialties on file
2

Practice location Address checks out

1775 Ballard Rd
Park Ridge, IL 60068-1005
Phone: (847) 318-9340
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 125.078664 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1265010045
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 1, 2021
Last updated in NPPESJune 14, 2021
Certification dateJune 14, 2021
Mailing address1775 Ballard Rd, Park Ridge, IL 60068-1005

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