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General NPI Number Information
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NPI Number | 1164711107
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Entity Type | Individual
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Provider Name | AMIT ISHWARLAL PATEL M.D
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Gender | Male
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 1969 W OGDEN AVE
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City | CHICAGO
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State | IL
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Zip | 60612-3765
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Country | US
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Telephone | 312-864-4783
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Fax |
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Provider Business Mailing Address
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Address Line | 18124 CRAWLEY RD
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City | ODESSA
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State | FL
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Zip | 33556-4828
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Country | US
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Telephone | 813-494-2049
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036-135086
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036.135086
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License Number State | IL
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