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General NPI Number Information
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NPI Number | 1134453897
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Entity Type | Organization
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Legal Business Name | GRISHMA P. PATEL, O.D. & ASSOCIATES, P.C.
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Dates
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Enumeration Date | 09/29/2009
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 1325 N MAIN ST
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City | WHEATON
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State | IL
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Zip | 60187-3579
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Country | US
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Telephone | 630-668-4144
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Fax | 630-668-7559
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Provider Business Mailing Address
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Address Line | 1325 N MAIN ST
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City | WHEATON
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State | IL
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Zip | 60187-3579
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Country | US
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Telephone | 630-668-4144
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Fax | 630-668-7559
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Authorized Official
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Title or Position | OWNER
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Name | MRS. GRISHMA P PATEL
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Credential |
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Telephone | 630-668-4144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046-009678
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License Number State | IL
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