Provider Demographics
NPI:1083998256
Name:PATEL, SARANG R (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARANG
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2266 N LINCOLN AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-7600
Mailing Address - Country:US
Mailing Address - Phone:773-868-1550
Mailing Address - Fax:773-868-1555
Practice Address - Street 1:2266 N LINCOLN AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-7600
Practice Address - Country:US
Practice Address - Phone:773-868-1550
Practice Address - Fax:773-868-1555
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.289406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist