Healthcare Provider Details

I. General information

NPI: 1780670166
Provider Name (Legal Business Name): KAUSHIKBHAI S PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: KAUSHIKBHAI PATEL MD

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OGDEN AVE
AURORA IL
60504-7222
US

IV. Provider business mailing address

2000 OGDEN AVE
AURORA IL
60504-7222
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-6250
  • Fax: 630-978-6869
Mailing address:
  • Phone: 630-978-6250
  • Fax: 630-978-6869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number20266
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number036-072715
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: