Healthcare Provider Details

I. General information

NPI: 1104696012
Provider Name (Legal Business Name): PATEL MEDICAL GROUP P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20330 N DEER PARK BLVD STE 130
DEER PARK IL
60010-7222
US

IV. Provider business mailing address

20330 N DEER PARK BLVD STE 130
DEER PARK IL
60010-7222
US

V. Phone/Fax

Practice location:
  • Phone: 312-625-1889
  • Fax:
Mailing address:
  • Phone: 312-625-1889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. DARSHAN R PATEL
Title or Position: CEO
Credential: MD
Phone: 224-388-1430