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General NPI Number Information
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NPI Number | 1437538246
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Entity Type | Organization
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Legal Business Name | SANJAY PATEL, LLC
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Dates
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Enumeration Date | 05/26/2015
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 9008 INDIANAPOLIS BLVD
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City | HIGHLAND
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State | IN
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Zip | 46322-2501
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Country | US
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Telephone | 219-513-8923
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Fax | 219-513-8941
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Provider Business Mailing Address
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Address Line | 6756 FIELDSTONE DR
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City | BURR RIDGE
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State | IL
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Zip | 60527-5298
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Country | US
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Telephone | 219-805-4244
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Fax | 219-513-8941
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANJAY C. PATEL
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Credential | MD
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Telephone | 219-805-4244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 01060936
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License Number State | IN
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