Healthcare Provider Details

I. General information

NPI: 1235710302
Provider Name (Legal Business Name): PRARTHANA PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W HARRISON ST STE 970
CHICAGO IL
60612-3828
US

IV. Provider business mailing address

1725 W HARRISON ST STE 970
CHICAGO IL
60612-3828
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-6296
  • Fax:
Mailing address:
  • Phone: 312-942-6296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number036.168136
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberW3592
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: