Provider Demographics
NPI:1326527953
Name:PATEL, KRUPESH P (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:KRUPESH
Middle Name:P
Last Name:PATEL
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 W CATALPA LN
Mailing Address - Street 2:
Mailing Address - City:MT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4560
Mailing Address - Country:US
Mailing Address - Phone:847-902-6503
Mailing Address - Fax:
Practice Address - Street 1:1355 REMINGTON RD STE H
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4818
Practice Address - Country:US
Practice Address - Phone:630-701-9009
Practice Address - Fax:630-701-9010
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.017925363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily