Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 036 044119 | IL |
NPI | 1003972365 |
---|---|
Provider Name | Ashok R Patel |
First Address | Chicago, IL 60657-6156 |
Second Address | Chicago, IL 60657-6156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D13017 | (02) | IL |