Healthcare Provider Details

I. General information

NPI: 1861308587
Provider Name (Legal Business Name): NISHIL K PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 S NORTHWEST HWY
PALATINE IL
60074-6231
US

IV. Provider business mailing address

1896 W GREENLEAF DR
ROUND LAKE IL
60073-9772
US

V. Phone/Fax

Practice location:
  • Phone: 224-218-2984
  • Fax:
Mailing address:
  • Phone: 847-530-5324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: