Healthcare Provider Details

I. General information

NPI: 1457663320
Provider Name (Legal Business Name): SEJAL PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 S MICHIGAN AVE
CHICAGO IL
60653-1019
US

IV. Provider business mailing address

3525 S MICHIGAN AVE
CHICAGO IL
60653-1019
US

V. Phone/Fax

Practice location:
  • Phone: 312-945-4040
  • Fax: 312-945-4011
Mailing address:
  • Phone: 312-945-4040
  • Fax: 312-945-4011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number15347-320
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125.058876
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: