MEDICARE: JAYNA PATEL DO

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	036.166111	IL

General Provider Information

NPI Number	:	1568041986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYNA PATEL DO

Provider Business Mailing Address
First Line	:	20201 CRAWFORD AVE
Second Line	:
City	:	OLYMPIA FIELDS
State	:	IL
Zip	:	60461-1010
Country	:	US
Telephone Number	:	708-747-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1775 BALLARD RD
Second Line	:
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-1005
Country	:	US
Telephone Number	:	847-318-6020
Fax Number	:	847-318-2341

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

Provider Enumeration Date	:	04/04/2021
Last Update Date	:	05/15/2026

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Directions to “ JAYNA PATEL DO” Practice Location

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