Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 070.020505 | IL |
NPI | 1003291253 |
---|---|
Provider Name | Kaminibahen Patel |
First Address | Carol Stream, IL 60188-1986 |
Second Address | Carol Stream, IL 60188-1986 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2015 |
Last Update Date | 29/07/2015 |