Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PENDING | IL |
NPI | 1073809752 |
---|---|
Provider Name | Roshni Ramesh Patel |
First Address | Chicago, IL 60611-3470 |
Second Address | Chicago, IL 60607-4709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2011 |
Last Update Date | 22/06/2011 |