MEDICARE: MRS. DAINISHA VASANT PATEL R.PH.

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	183500000X	Pharmacist		IL

General Provider Information

NPI Number	:	1912033119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAINISHA VASANT PATEL R.PH.

Provider Business Mailing Address
First Line	:	8245 KILBOURN AVE
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60076-2613
Country	:	US
Telephone Number	:	847-679-0130
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 BIERMANN CT
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-2151
Country	:	US
Telephone Number	:	847-634-7900
Fax Number	:

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

Provider Enumeration Date	:	02/24/2007
Last Update Date	:	07/08/2007

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