Provider Demographics
NPI:1013004670
Name:PATEL, JATEEN C (MD)
Entity Type:Individual
Prefix:
First Name:JATEEN
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1555 BARRINGTON RD
Mailing Address - Street 2:DOCTORS BLDG 1, SUITE 415
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1019
Mailing Address - Country:US
Mailing Address - Phone:847-490-4222
Mailing Address - Fax:847-490-4225
Practice Address - Street 1:1555 BARRINGTON RD
Practice Address - Street 2:DOCTORS BLDG 1, SUITE 415
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1019
Practice Address - Country:US
Practice Address - Phone:847-490-4222
Practice Address - Fax:847-490-4225
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO417772086S0120X
NDPT133902086S0120X
IL036-1283742086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-128374Medicaid
CO20333536Medicaid
NDN720282Medicare PIN
CO20333536Medicaid