Provider Demographics
NPI:1114513306
Name:PATEL, SHAHEEN (DNP)
Entity Type:Individual
Prefix:
First Name:SHAHEEN
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:9831 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-1740
Practice Address - Country:US
Practice Address - Phone:773-445-3500
Practice Address - Fax:773-445-0575
Is Sole Proprietor?:No
Enumeration Date:2020-12-12
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.411637163WG0100X
IL209022951363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterology