Healthcare Provider Details

I. General information

NPI: 1326500661
Provider Name (Legal Business Name): RIKI PATEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S. YORK ST. OUTPATIENT SURGERY CENTER
ELMHURST IL
60126-5626
US

IV. Provider business mailing address

1200 S. YORK ST. OUTPATIENT SURGERY CENTER
ELMHURST IL
60126-5626
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-6360
  • Fax: 331-221-3827
Mailing address:
  • Phone: 331-221-6360
  • Fax: 331-221-3827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036158735
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: