Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | IL |
NPI | 1154362754 |
---|---|
Provider Name | Dr. Nishitkumar S Patel |
First Address | Chicago, IL 60674-0035 |
Second Address | Chicago, IL 60608-1732 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G64693 | (02) | IL |