MEDICARE: KIRTAN 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	207Q00000X	Family Medicine Physician	125084652	IL

General Provider Information

NPI Number	:	1609610302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRTAN PATEL MD

Provider Business Mailing Address
First Line	:	3249 OAK PARK AVE
Second Line	:
City	:	BERWYN
State	:	IL
Zip	:	60402-3429
Country	:	US
Telephone Number	:	708-783-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4220 W 95TH ST
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-2793
Country	:	US
Telephone Number	:	312-949-4200
Fax Number	:

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

Provider Enumeration Date	:	06/19/2024
Last Update Date	:	12/08/2025

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Directions to “ KIRTAN PATEL MD” Practice Location

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