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NPI Code Detail

MEDICARE: DR. MIKIN VIRENDRA PATEL MD

MEDICARE: DR. MIKIN VIRENDRA PATEL MD
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
12085R0204XVascular & Interventional Radiology Physician036151026IL
22085R0202XDiagnostic Radiology Physician36.151026IL

General Provider Information

NPI Number : 1609121219
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIKIN VIRENDRA PATEL MD
Provider Business Mailing Address
First Line : 4062 DEPARTMENT
Second Line :
City : CAROL STREAM
State : IL
Zip : 60122-4062
Country : US
Telephone Number : 888-653-7107
Fax Number : 706-653-1230
Provider Business Practice Location Address
First Line : 1870 W WINCHESTER RD STE 146
Second Line :
City : LIBERTYVILLE
State : IL
Zip : 60048-5359
Country : US
Telephone Number : 847-584-3959
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2012
Last Update Date : 04/09/2026

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