Healthcare Provider Details

I. General information

NPI: 1689779357
Provider Name (Legal Business Name): YAQUTA PATNI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 OGDEN AVE
AURORA IL
60504-5894
US

IV. Provider business mailing address

143 N WRIGHT ST
NAPERVILLE IL
60540-4747
US

V. Phone/Fax

Practice location:
  • Phone: 630-692-5060
  • Fax:
Mailing address:
  • Phone: 206-437-2948
  • Fax: 229-299-9760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number036106333
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: