Provider Demographics
NPI:1275300675
Name:PATEL, ASHA B (PSYCHIATRIC NP)
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:B
Last Name:PATEL
Suffix:
Gender:F
Credentials:PSYCHIATRIC NP
Other - Prefix:
Other - First Name:ASHABEN
Other - Middle Name:B
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYCHIATRIC NP
Mailing Address - Street 1:3223 N SHEFFIELD AVE STE C
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-7231
Mailing Address - Country:US
Mailing Address - Phone:630-755-5276
Mailing Address - Fax:
Practice Address - Street 1:3223 N SHEFFIELD AVE STE C
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-7231
Practice Address - Country:US
Practice Address - Phone:630-755-5276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209028646363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health