MEDICARE: DR. PRANAV YOGESH PATEL DDS

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	122300000X	Dentist	019026243	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	:	1174657274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRANAV YOGESH PATEL DDS

Provider Business Mailing Address
First Line	:	319 S BARRINGTON RD
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60193-5345
Country	:	US
Telephone Number	:	847-534-1100
Fax Number	:	847-534-0011

Provider Business Practice Location Address
First Line	:	319 S BARRINGTON RD
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60193-5345
Country	:	US
Telephone Number	:	847-534-1100
Fax Number	:	847-534-0011

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	03/17/2018

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