Provider Demographics
NPI:1164704359
Name:PATEL, RAMESH M (RPH)
Entity Type:Individual
Prefix:
First Name:RAMESH
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 N NAGLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-3614
Mailing Address - Country:US
Mailing Address - Phone:773-774-2225
Mailing Address - Fax:773-774-4719
Practice Address - Street 1:6310 N NAGLE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-3614
Practice Address - Country:US
Practice Address - Phone:773-774-2225
Practice Address - Fax:773-774-4719
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-032859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist