Provider Demographics
NPI:1326169202
Name:ISHWAR K. PATEL, M.D., S.C.
Entity Type:Organization
Organization Name:ISHWAR K. PATEL, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISHWAR
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-882-2577
Mailing Address - Street 1:1555 BARRINGTON RD, SUITE 130
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5026
Mailing Address - Country:US
Mailing Address - Phone:847-882-2577
Mailing Address - Fax:847-882-2550
Practice Address - Street 1:1555 BARRINGTON RD, SUITE 130
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5026
Practice Address - Country:US
Practice Address - Phone:847-882-2577
Practice Address - Fax:847-882-2550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD13312Medicare UPIN
IL667620Medicare ID - Type Unspecified