Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | IL |
NPI | 1083697692 |
---|---|
Provider Name | Dr. Ankit M Patel |
First Address | Joliet, IL 60435-5574 |
Second Address | Joliet, IL 60435-5574 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 13/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC1387 | RR MEDICARE (01) | IL |
H88775 | (02) | IL |
K08804 | GRUNDY CO MEDICARE PROV # (01) | IL |
K08805 | WILL CO MEDICARE PROV # (01) | IL |
P00150113 | RR MEDICARE PROV ID# (01) | IL |