Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 036150151 | IL |
NPI | 1053737643 |
---|---|
Provider Name | Parin Patel |
First Address | Champaign, IL 61820-3909 |
Second Address | Champaign, IL 61822-3743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2014 |
Last Update Date | 05/01/2022 |