Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 277-000633 | IL |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 209008149 | IL |
NPI | 1023337672 |
---|---|
Provider Name | Mansi P Patel |
First Address | Downers Grove, IL 60515-1160 |
Second Address | Downers Grove, IL 60515-1160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2010 |
Last Update Date | 18/11/2020 |