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General NPI Number Information
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NPI Number | 1992013379
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Entity Type | Individual
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Provider Name | JIGAR PANCHAL PT
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Gender | Male
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Dates
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Enumeration Date | 09/19/2010
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 2021 MIDWEST RD STE 103
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City | OAK BROOK
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State | IL
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Zip | 60523-8902
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Country | US
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Telephone | 630-451-9020
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Fax | 630-451-9025
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Provider Business Mailing Address
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Address Line | 2134 STIRLING CT
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City | HANOVER PARK
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State | IL
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Zip | 60133-2962
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Country | US
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Telephone | 630-329-2170
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070018020
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License Number State | IL
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