Healthcare Provider Details
I. General information
NPI: 1902215411
Provider Name (Legal Business Name): EPIC FAMILY CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/08/2014
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
770 E DUNDEE RD
PALATINE IL
60074-2858
US
IV. Provider business mailing address
770 EAST DUNDEE ROAD
PALATINE IL
60074-5339
US
V. Phone/Fax
- Phone: 708-733-7750
- Fax:
- Phone: 708-733-7750
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HEMAL
K
PATEL
Title or Position: MD/OWNER
Credential: MD
Phone: 630-835-2896