Healthcare Provider Details

I. General information

NPI: 1346808243
Provider Name (Legal Business Name): AASHKA PATEL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 N CLARK ST STE 400
CHICAGO IL
60610-5468
US

IV. Provider business mailing address

1411 W HURON ST APT 2
CHICAGO IL
60642-6213
US

V. Phone/Fax

Practice location:
  • Phone: 312-943-6964
  • Fax:
Mailing address:
  • Phone: 630-709-2752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125074582
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036.160266
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: