MEDICARE: DR. PRANAV K PATEL D.C.

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	111N00000X	Chiropractor	038-009617	IL

General Provider Information

NPI Number	:	1952496432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRANAV K PATEL D.C.

Provider Business Mailing Address
First Line	:	468 LAKE ST
Second Line	:
City	:	ROSELLE
State	:	IL
Zip	:	60172-3544
Country	:	US
Telephone Number	:	847-466-5009
Fax Number	:	847-466-5407

Provider Business Practice Location Address
First Line	:	468 LAKE ST
Second Line	:
City	:	ROSELLE
State	:	IL
Zip	:	60172-3544
Country	:	US
Telephone Number	:	847-466-5009
Fax Number	:	847-466-5407

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/14/2021

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