Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 036142750 | IL |
NPI | 1124438643 |
---|---|
Provider Name | Gayatri Patel |
First Address | Chicago, IL 60611-5980 |
Second Address | Chicago, IL 60611-5980 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2014 |
Last Update Date | 06/08/2020 |