Healthcare Provider Details

I. General information

NPI: 1346116183
Provider Name (Legal Business Name): MINAL J PATEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11845 SOUTHWEST HWY UNIT 12
PALOS HEIGHTS IL
60463-1599
US

IV. Provider business mailing address

11845 SOUTHWEST HWY UNIT 12
PALOS HEIGHTS IL
60463-1599
US

V. Phone/Fax

Practice location:
  • Phone: 708-923-5422
  • Fax: 708-923-5458
Mailing address:
  • Phone: 708-923-5422
  • Fax: 708-923-5458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085011879
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: