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General NPI Number Information
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NPI Number | 1356685507
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Entity Type | Individual
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Provider Name | ARTI PATEL PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/11/2012
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Last Update Date | 11/11/2012
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Provider Practice Location Address
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Address Line | 2331 W CHICAGO AVE
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City | CHICAGO
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State | IL
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Zip | 60622-4723
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Country | US
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Telephone | 773-772-7858
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Fax |
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Provider Business Mailing Address
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Address Line | 1624 S ELM ST
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City | DES PLAINES
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State | IL
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Zip | 60018-2214
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Country | US
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Telephone |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 085-004545
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License Number State | IL
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