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NPI Code Detail

MEDICARE: DR. RADHIKA PATEL OD

MEDICARE: DR. RADHIKA PATEL OD
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
1152W00000XOptometrist046-010661IL

General Provider Information

NPI Number : 1538596820
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RADHIKA PATEL OD
Provider Business Mailing Address
First Line : 5455 HARRISON PARK LN
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46216-2245
Country : US
Telephone Number : 317-254-6480
Fax Number : 317-259-8609
Provider Business Practice Location Address
First Line : 6322 S ARCHER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60638-2521
Country : US
Telephone Number : 773-585-2022
Fax Number : 773-585-2027
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2013
Last Update Date : 10/01/2013

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