Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 036138791 | IL |
NPI | 1003175829 |
---|---|
Provider Name | Nikita Ghanshyam Patel |
First Address | Arlington Heights, IL 60004 |
Second Address | Arlington Heights, IL 60004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2012 |
Last Update Date | 21/08/2015 |