Healthcare Provider Details

I. General information

NPI: 1346535804
Provider Name (Legal Business Name): RASHMI PATEL MD SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 06/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 E PERSHING RD
CHICAGO IL
60653-1917
US

IV. Provider business mailing address

625 E PERSHING RD
CHICAGO IL
60653-1917
US

V. Phone/Fax

Practice location:
  • Phone: 773-592-9501
  • Fax: 773-538-6963
Mailing address:
  • Phone: 773-592-9501
  • Fax: 773-538-6963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RASHMI C PATEL
Title or Position: DIRECTOR
Credential: M.D.
Phone: 773-592-9501