Healthcare Provider Details

I. General information

NPI: 1992553374
Provider Name (Legal Business Name): KINJAL R PATEL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 E WOODFIELD RD STE 300
SCHAUMBURG IL
60173-4776
US

IV. Provider business mailing address

804 E WOODFIELD RD STE 300
SCHAUMBURG IL
60173-4776
US

V. Phone/Fax

Practice location:
  • Phone: 847-605-8700
  • Fax: 847-605-8700
Mailing address:
  • Phone: 847-605-8700
  • Fax: 847-605-8700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209030140
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: