Provider Demographics
NPI:1407473218
Name:PATEL, MILAN VIJAY (DPM)
Entity Type:Individual
Prefix:
First Name:MILAN
Middle Name:VIJAY
Last Name:PATEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 S BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4505
Mailing Address - Country:US
Mailing Address - Phone:847-385-1181
Mailing Address - Fax:
Practice Address - Street 1:396 REMINGTON BLVD STE 141
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-4302
Practice Address - Country:US
Practice Address - Phone:630-418-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL135.001090213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery