Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OS10455 | FL |
N | 111NI0900X | Internist | OS10455 | FL |
Y | 207RH0002X | Hospice and Palliative Medicine | 036121661 | IL |
NPI | 1134385420 |
---|---|
Provider Name | Dr. Malkan G Patel |
First Address | Mt Prospect, IL 60056-6039 |
Second Address | Mt Prospect, IL 60056-6039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2008 |
Last Update Date | 20/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000389900 | (05) | FL |
BF911Z | PTAN (01) | FL |