MEDICARE: DR. RICKYN PRAKASH PATEL D.O.

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	207R00000X	Internal Medicine Physician	BP10037099	TX
2	207RC0000X	Cardiovascular Disease Physician	02004853A	IN
3	207RC0000X	Cardiovascular Disease Physician	036167410	IL

General Provider Information

NPI Number	:	1972821825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICKYN PRAKASH PATEL D.O.

Provider Business Mailing Address
First Line	:	7447 W TALCOTT AVE STE 222
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-3713
Country	:	US
Telephone Number	:	733-262-2447
Fax Number	:	773-774-8580

Provider Business Practice Location Address
First Line	:	7447 W TALCOTT AVE STE 222
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-3713
Country	:	US
Telephone Number	:	773-326-2244
Fax Number	:	737-748-5807

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

Provider Enumeration Date	:	05/16/2010
Last Update Date	:	06/12/2024

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