Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MDO.36681 LL | SC |
Y | 2080P0216X | Pediatric Rheumatologist | 036.152779 | IL |
NPI | 1477966323 |
---|---|
Provider Name | Pooja Nikunj Patel |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2014 |
Last Update Date | 18/08/2020 |