Provider Demographics
NPI:1215223581
Name:PATEL, NINA (DO)
Entity Type:Individual
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First Name:NINA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2740 W FOSTER AVE
Mailing Address - Street 2:STE 401
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3591
Mailing Address - Country:US
Mailing Address - Phone:773-907-3400
Mailing Address - Fax:773-907-0341
Practice Address - Street 1:2740 W FOSTER AVE
Practice Address - Street 2:STE 401
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3591
Practice Address - Country:US
Practice Address - Phone:773-907-3400
Practice Address - Fax:773-907-0341
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-24
Last Update Date:2017-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036134939207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILRES000Medicare UPIN