MEDICARE: VIJAY PATEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	036060465	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326097585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIJAY PATEL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 10428
Second Line	:
City	:	MERRILLVILLE
State	:	IN
Zip	:	46411-0428
Country	:	US
Telephone Number	:	219-681-2065
Fax Number	:	219-681-2066

Provider Business Practice Location Address
First Line	:	2315 E 93RD ST
Second Line	:	SUITE 340
City	:	CHICAGO
State	:	IL
Zip	:	60617-3910
Country	:	US
Telephone Number	:	773-721-0322
Fax Number	:	773-721-1471

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	01/24/2011

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Directions to “ VIJAY PATEL M.D.” Practice Location

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