Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 036138388 | IL |
NPI | 1033422209 |
---|---|
Provider Name | Dr. Savan Dixit Patel |
First Address | Crystal Lake, IL 60012-3709 |
Second Address | Crystal Lake, IL 60012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2010 |
Last Update Date | 25/09/2019 |