Provider Demographics
NPI:1194221770
Name:PATEL, NISHA BHARAT (DO)
Entity Type:Individual
Prefix:
First Name:NISHA
Middle Name:BHARAT
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S SPRINGINSGUTH RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-1270
Mailing Address - Country:US
Mailing Address - Phone:847-715-8542
Mailing Address - Fax:
Practice Address - Street 1:EDWARDS MEDICAL PLAZA SUITE 320
Practice Address - Street 2:1300 NORTH 12TH STREET
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006
Practice Address - Country:US
Practice Address - Phone:602-521-3617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program