Healthcare Provider Details

I. General information

NPI: 1881336576
Provider Name (Legal Business Name): TUSHARBHAI JIGNESHKUMAR PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S PAULINA ST
CHICAGO IL
60612-3806
US

IV. Provider business mailing address

1725 W HARRISON ST STE 1159
CHICAGO IL
60612-3883
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberV6669
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036179877
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberV6669
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: