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General NPI Number Information
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NPI Number | 1760111769
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Entity Type | Individual
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Provider Name | SAJNI PATEL DMD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | GANGER FAMILY DENTISTRY OF CHICAGO 1858 W 35TH STREET
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City | CHICAGO
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State | IL
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Zip | 60609
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Country | US
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Telephone | 773-247-5554
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Fax |
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Provider Business Mailing Address
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Address Line | 727 W MADISON ST APT 1406
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City | CHICAGO
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State | IL
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Zip | 60661-2409
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Country | US
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Telephone | 708-262-6772
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.033593
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License Number State | IL
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