Healthcare Provider Details

I. General information

NPI: 1740817279
Provider Name (Legal Business Name): HENNAH NIMESH PATEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 OGDEN AVE STE 201
AURORA IL
60504-7205
US

IV. Provider business mailing address

2000 OGDEN AVE STE P050
AURORA IL
60504-5893
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-6886
  • Fax: 630-978-6806
Mailing address:
  • Phone: 630-499-2404
  • Fax: 630-499-4750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5151014435
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number036169238
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036169238
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: