Healthcare Provider Details

I. General information

NPI: 1568181329
Provider Name (Legal Business Name): DARSHIKKUMAR SHASHIKANT PATEL APRN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 S WEBER RD
ROMEOVILLE IL
60446-3980
US

IV. Provider business mailing address

245 S WEBER RD
ROMEOVILLE IL
60446-3980
US

V. Phone/Fax

Practice location:
  • Phone: 630-597-1234
  • Fax: 833-764-5477
Mailing address:
  • Phone: 630-597-1234
  • Fax: 833-764-5477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277004400
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number32009
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number277004400
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: