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General NPI Number Information
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NPI Number | 1679455505
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Entity Type | Organization
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Legal Business Name | RAJUL PATEL WEST LOOP PC
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 1755 W NORTH AVE STE C-101
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City | CHICAGO
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State | IL
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Zip | 60622-5450
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Country | US
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Telephone | 773-527-2790
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Fax | 630-307-3134
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Provider Business Mailing Address
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Address Line | 107 W LAKE ST STE 101
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1027
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Country | US
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Telephone | 630-307-3133
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Fax | 630-307-3134
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | MRS. CRYSTAL BLEDSOE BARRON
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Credential |
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Telephone | 813-580-0028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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