MEDICARE: DR. RASHMIKA B PATEL D.D.S.

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	1223G0001X	General Practice Dentistry		IL

General Provider Information

NPI Number	:	1073644605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RASHMIKA B PATEL D.D.S.

Provider Business Mailing Address
First Line	:	7140 DEMPSTER ST
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2053
Country	:	US
Telephone Number	:	847-967-8999
Fax Number	:	847-965-8991

Provider Business Practice Location Address
First Line	:	7140 DEMPSTER ST
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2053
Country	:	US
Telephone Number	:	847-967-8999
Fax Number	:	847-965-8991

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/08/2007

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