Healthcare Provider Details

I. General information

NPI: 1154234466
Provider Name (Legal Business Name): KIRANBEN K PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8671 JOSEPHINE ST APT C
DES PLAINES IL
60016-1876
US

IV. Provider business mailing address

8671 JOSEPHINE ST APT C
DES PLAINES IL
60016-1876
US

V. Phone/Fax

Practice location:
  • Phone: 224-392-4784
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number41558136
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: