Healthcare Provider Details

I. General information

NPI: 1437392743
Provider Name (Legal Business Name): SWATI SURESH PATEL MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2009
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 N MICHIGAN AVE SUITE 103
CHICAGO IL
60602-4811
US

IV. Provider business mailing address

24 E CHICAGO AVE
CHICAGO IL
60611-2009
US

V. Phone/Fax

Practice location:
  • Phone: 312-236-0660
  • Fax: 312-236-1219
Mailing address:
  • Phone: 312-951-9700
  • Fax: 312-951-6989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberT1429
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056-009597
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: