Healthcare Provider Details
I. General information
NPI: 1659294866
Provider Name (Legal Business Name): BEACON MIDWEST PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3490 HAROLD CIR
HOFFMAN ESTATES IL
60192-2000
US
IV. Provider business mailing address
3490 HAROLD CIR
HOFFMAN ESTATES IL
60192-2000
US
V. Phone/Fax
- Phone: 630-965-4154
- Fax:
- Phone: 630-965-4154
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PURVI
PATEL
Title or Position: OWNER
Credential: APN
Phone: 630-965-4154