Healthcare Provider Details

I. General information

NPI: 1801707922
Provider Name (Legal Business Name): PATEL PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 WILLOW SPRINGS RD STE 110
LA GRANGE HIGHLANDS IL
60525-6504
US

IV. Provider business mailing address

720 S MITCHELL AVE
ELMHURST IL
60126-4372
US

V. Phone/Fax

Practice location:
  • Phone: 815-814-4966
  • Fax:
Mailing address:
  • Phone: 847-477-1279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: PRACHI PATEL
Title or Position: PHYSICIAN OWNER
Credential: D.O.
Phone: 847-477-1279