Healthcare Provider Details

I. General information

NPI: 1194763250
Provider Name (Legal Business Name): RAJIV J PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 12/27/2021
Certification Date: 12/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BIESTERFIELD RD
ELK GROVE VILLAGE IL
60007-3361
US

IV. Provider business mailing address

700 COMMERCE DR SUITE 500
OAK BROOK IL
60523-1546
US

V. Phone/Fax

Practice location:
  • Phone: 847-981-5760
  • Fax: 847-956-5138
Mailing address:
  • Phone: 847-698-0601
  • Fax: 847-698-0601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number4301078605
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number036.120461
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: