Healthcare Provider Details

I. General information

NPI: 1205576154
Provider Name (Legal Business Name): NIRALI PATEL MD, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MADISON ST STE 300
OAK PARK IL
60302-4210
US

IV. Provider business mailing address

1875 W DEMPSTER ST STE 525
PARK RIDGE IL
60068-1130
US

V. Phone/Fax

Practice location:
  • Phone: 708-486-2700
  • Fax: 708-486-2702
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036.175597
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.175597
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: