MEDICARE: DR. BANSI PATEL DMD

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	1223G0001X	General Practice Dentistry	019034415	IL

General Provider Information

NPI Number	:	1386424661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BANSI PATEL DMD

Provider Business Mailing Address
First Line	:	1865 MAINE DR
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-2728
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	990 GRAND CANYON PKWY STE 215
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-1735
Country	:	US
Telephone Number	:	847-885-1680
Fax Number	:

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

Provider Enumeration Date	:	10/03/2023
Last Update Date	:	11/30/2025

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