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General NPI Number Information
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NPI Number | 1407473218
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Entity Type | Individual
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Provider Name | MILAN VIJAY PATEL DPM
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Gender | Male
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 396 REMINGTON BLVD STE 141
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4302
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Country | US
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Telephone | 630-418-6601
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Fax |
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Provider Business Mailing Address
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Address Line | 1435 S BIRCH DR
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056-4505
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Country | US
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Telephone | 847-385-1181
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 135.001090
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License Number State | IL
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