MEDICARE: MR. PRADIP R PATEL RPH

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	183500000X	Pharmacist		IL

General Provider Information

NPI Number	:	1275685364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PRADIP R PATEL RPH

Provider Business Mailing Address
First Line	:	1010 RIDGEWOOD DR
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-5002
Country	:	US
Telephone Number	:	630-231-7049
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 RIDGEWOOD DR
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-5002
Country	:	US
Telephone Number	:	630-231-7049
Fax Number	:

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	07/08/2007

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