Healthcare Provider Details

I. General information

NPI: 1366971970
Provider Name (Legal Business Name): AVANI HEMANT KUMAR PATEL APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PFINGSTEN RD. SUITE 3000
GLENVIEW IL
60026-1314
US

IV. Provider business mailing address

2150 PFINGSTEN RD. SUITE 3000
GLENVIEW IL
60026-1314
US

V. Phone/Fax

Practice location:
  • Phone: 847-657-1900
  • Fax: 847-657-1961
Mailing address:
  • Phone: 847-657-1900
  • Fax: 847-657-1961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209016012
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209016012
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: