MEDICARE: HIMALI PATEL DMD

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	1223G0001X	General Practice Dentistry	12015050A	IN

General Provider Information

NPI Number	:	1801729785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIMALI PATEL DMD

Provider Business Mailing Address
First Line	:	1200 S LESLIE LN
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60018-5535
Country	:	US
Telephone Number	:	847-895-9003
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 ALFRED ST
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-7303
Country	:	US
Telephone Number	:	219-872-6200
Fax Number	:	219-879-2915

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

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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