MEDICARE: DHARA PATEL APN-CNP

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	163W00000X	Registered Nurse	041387217	IL
2	363L00000X	Nurse Practitioner	209028238	IL
3	363LF0000X	Family Nurse Practitioner	209028238	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	209028238	OTHER	IL	STATE LICENSE

General Provider Information

NPI Number	:	1013643378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DHARA PATEL APN-CNP

Provider Business Mailing Address
First Line	:	1051 W RAND RD STE 110
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-2315
Country	:	US
Telephone Number	:	847-618-9292
Fax Number	:	847-618-9294

Provider Business Practice Location Address
First Line	:	1051 W RAND RD # 110
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-2315
Country	:	US
Telephone Number	:	847-618-9292
Fax Number	:	847-618-9294

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2022
Last Update Date	:	03/26/2026

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Directions to “ DHARA PATEL APN-CNP” Practice Location

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