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General NPI Number Information
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NPI Number | 1316110893
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Entity Type | Organization
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Legal Business Name | ROHIDAS T PATIL MD SC
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 1770 E LAKE SHORE DR SUITE 209
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City | DECATUR
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State | IL
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Zip | 62521-3832
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Country | US
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Telephone | 217-423-6500
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Fax | 217-423-6536
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Provider Business Mailing Address
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Address Line | 1770 E LAKE SHORE DR SUITE 209
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City | DECATUR
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State | IL
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Zip | 62521-3832
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Country | US
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Telephone | 217-423-6500
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Fax | 217-423-6536
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. ROHI PATIL
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Credential | MD
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Telephone | 217-423-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036-052881
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License Number State | IL
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