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General NPI Number Information
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NPI Number | 1659818607
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Entity Type | Individual
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Provider Name | RADHIKA PATEL AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/30/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 251 E HURON ST
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City | CHICAGO
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State | IL
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Zip | 60611-2908
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Country | US
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Telephone | 312-926-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 51299 PLYMOUTH RIDGE DR
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City | PLYMOUTH
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State | MI
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Zip | 48170-6392
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Country | US
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Telephone | 313-516-9887
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 4704300441
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041453108
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209016254
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License Number State | IL
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