=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902008006
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TORAL ARUN PATEL M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2007
-----------------------------------------------------
Last Update Date | 06/16/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2900 N LAKE SHORE DR #1231
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60657-5640
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-402-8735
-----------------------------------------------------
Fax | 772-665-9435
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2900 N LAKE SHORE DR #1231
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60657-5640
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-402-8735
-----------------------------------------------------
Fax | 773-665-9435
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 4301084475
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RI0200X
-----------------------------------------------------
Taxonomy Name | Infectious Disease Physician
-----------------------------------------------------
License Number | 036-119118
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------