MEDICARE: BHANU L PATEL M D LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	036090924	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003156373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BHANU L PATEL M D LTD

Provider Business Mailing Address
First Line	:	3414 W PETERSON AVE
Second Line	:	SUITE A
City	:	CHICAGO
State	:	IL
Zip	:	60659-3452
Country	:	US
Telephone Number	:	773-478-1777
Fax Number	:	877-224-8698

Provider Business Practice Location Address
First Line	:	3414 W PETERSON AVE
Second Line	:	SUITE A
City	:	CHICAGO
State	:	IL
Zip	:	60659-3452
Country	:	US
Telephone Number	:	773-478-1777
Fax Number	:	877-224-8698

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BHANU PATEL
Credential	:	MD
Telephone Number	:	773-478-1777

Provider Enumeration Date	:	02/25/2013
Last Update Date	:	04/29/2024

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Directions to “BHANU L PATEL M D LTD ” Practice Location

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