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NPI Code Detail

MEDICARE: DR. MALKAN G PATEL D.O., M.S.

MEDICARE: DR. MALKAN G PATEL D.O., M.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
1207R00000XInternal Medicine PhysicianOS10455FL
2207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician036121661IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1BF911ZOTHERFLPTAN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134385420
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MALKAN G PATEL D.O., M.S.
Provider Business Mailing Address
First Line : 1550 BISHOP CT
Second Line :
City : MT PROSPECT
State : IL
Zip : 60056-6039
Country : US
Telephone Number : 954-644-0284
Fax Number : 866-567-9335
Provider Business Practice Location Address
First Line : 1550 BISHOP CT
Second Line :
City : MT PROSPECT
State : IL
Zip : 60056-6039
Country : US
Telephone Number : 954-644-0284
Fax Number : 866-567-9335
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2008
Last Update Date : 10/20/2016

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