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General NPI Number Information
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NPI Number | 1972039469
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Entity Type | Individual
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Provider Name | DIPEEKA PATEL N.P.,
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Gender | Female
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 430 E 162ND ST # 487
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473
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Country | US
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Telephone | 708-880-0559
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Fax | 708-896-6141
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Provider Business Mailing Address
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Address Line | 430 E 162ND ST # 487
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473-2258
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Country | US
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Telephone | 708-880-0559
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Fax | 708-896-6141
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 209.016779
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 209.016779
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209.016779
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License Number State | IL
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