MEDICARE: DR. MIKIN VIRENDRA 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
1	2085R0202X	Diagnostic Radiology Physician	36.151026	IL
2	2085R0204X	Vascular & Interventional Radiology Physician	036151026	IL

General Provider Information

NPI Number	:	1609121219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIKIN VIRENDRA PATEL MD

Provider Business Mailing Address
First Line	:	4062 DEPARTMENT
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60122-4062
Country	:	US
Telephone Number	:	888-653-7107
Fax Number	:	706-653-1230

Provider Business Practice Location Address
First Line	:	5145 N CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3661
Country	:	US
Telephone Number	:	773-989-6222
Fax Number	:	706-653-1230

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

Provider Enumeration Date	:	07/19/2012
Last Update Date	:	01/05/2026

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