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General NPI Number Information
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NPI Number | 1538596820
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Entity Type | Individual
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Provider Name | RADHIKA PATEL OD
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Gender | Female
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Dates
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Enumeration Date | 10/01/2013
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Last Update Date | 10/01/2013
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Provider Practice Location Address
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Address Line | 6322 S ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-2521
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Country | US
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Telephone | 773-585-2022
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Fax | 773-585-2027
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Provider Business Mailing Address
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Address Line | 5455 HARRISON PARK LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46216-2245
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Country | US
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Telephone | 317-254-6480
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Fax | 317-259-8609
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046-010661
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License Number State | IL
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