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NPI Code Detail

MEDICARE: ISA PATEL PHARMD

MEDICARE: ISA PATEL PHARMD
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
1183500000XPharmacist051294676IL

General Provider Information

NPI Number : 1538461678
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISA PATEL PHARMD
Provider Business Mailing Address
First Line : 650 WARRENVILLE RD
Second Line :
City : LISLE
State : IL
Zip : 60532-4314
Country : US
Telephone Number : 630-550-0502
Fax Number :
Provider Business Practice Location Address
First Line : 1128 CHICAGO AVENUE
Second Line :
City : CHICAGO
State : IL
Zip : 60202-1351
Country : US
Telephone Number : 630-550-0502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2010
Last Update Date : 01/17/2017

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Directions to “ ISA PATEL PHARMD” Practice Location

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