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General NPI Number Information
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NPI Number | 1881856094
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Entity Type | Organization
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Legal Business Name | SANJAY M. PATEL M.D. S.C.
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Dates
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Enumeration Date | 06/29/2008
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 645 S CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60644-5059
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Country | US
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Telephone | 773-463-1838
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Fax |
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Provider Business Mailing Address
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Address Line | 7N405 SYCAMORE AVE
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City | MEDINAH
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State | IL
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Zip | 60157-9408
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Country | US
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Telephone | 773-463-1838
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Fax |
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Authorized Official
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Title or Position | M.D. PSYCHIATRY
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Name | DR. SANJAY MAGAN PATEL
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Credential | M.D.
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Telephone | 773-456-6242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036118407
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License Number State | IL
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