Healthcare Provider Details

I. General information

NPI: 1588985147
Provider Name (Legal Business Name): SANGEETA P DRIVER M.D. M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANGEETA PATEL MD

II. Dates (important events)

Enumeration Date: 06/17/2010
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 E ERIE ST
CHICAGO IL
60611-3167
US

IV. Provider business mailing address

355 E ERIE ST
CHICAGO IL
60611-3167
US

V. Phone/Fax

Practice location:
  • Phone: 312-238-1000
  • Fax:
Mailing address:
  • Phone: 312-238-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number036-131981
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License Number036-131981
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: