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NPI Code Detail

MEDICARE: PAYAL PATEL MD

MEDICARE: PAYAL PATEL MD
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
1207Q00000XFamily Medicine Physician125077796IL

General Provider Information

NPI Number : 1497339162
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAYAL PATEL MD
Provider Business Mailing Address
First Line : 375 N WALL ST STE P310
Second Line :
City : KANKAKEE
State : IL
Zip : 60901-3484
Country : US
Telephone Number : 815-933-0194
Fax Number : 815-936-3847
Provider Business Practice Location Address
First Line : 375 N WALL ST STE P310
Second Line :
City : KANKAKEE
State : IL
Zip : 60901-3484
Country : US
Telephone Number : 815-933-0194
Fax Number : 815-936-3847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2021
Last Update Date : 09/11/2024

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Directions to “ PAYAL PATEL MD” Practice Location

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