Healthcare Provider Details

I. General information

NPI: 1164003562
Provider Name (Legal Business Name): RAHI PATEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2285 SEQUOIA DR
AURORA IL
60506-6209
US

IV. Provider business mailing address

28594 NETWORK PL
CHICAGO IL
60673-1293
US

V. Phone/Fax

Practice location:
  • Phone: 630-859-6910
  • Fax: 630-859-6811
Mailing address:
  • Phone: 847-390-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036-166491
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: