Healthcare Provider Details

I. General information

NPI: 1306062963
Provider Name (Legal Business Name): SHILPA J PATEL PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 PFINGSTEN RD SUITE 100
GLENVIEW IL
60026-1324
US

IV. Provider business mailing address

4043 BLAKE LN
GLENVIEW IL
60026-1092
US

V. Phone/Fax

Practice location:
  • Phone: 847-657-1785
  • Fax: 847-657-1787
Mailing address:
  • Phone: 847-715-0406
  • Fax: 847-715-1052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: