Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 016005446 | IL |
Y | 213ES0103X | Foot & Ankle Surgery | 016005446 | IL |
NPI | 1023245446 |
---|---|
Provider Name | Dr. Jagruti Patel |
First Address | Chicago, IL 60646-1100 |
Second Address | Chicago, IL 60646-1100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2009 |
Last Update Date | 19/01/2015 |