Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 038012243 | IL |
Y | 111NR0400X | Rehabilitation Chiropractor | 038012243 | IL |
NPI | 1215287644 |
---|---|
Provider Name | Dr. Mina Hirji Patel |
First Address | Chicago, IL 60614-7170 |
Second Address | Chicago, IL 60614-7170 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2012 |
Last Update Date | 10/11/2012 |