Provider Demographics
NPI:1407579444
Name:PATEL, SAVAN MUKESH (RPH)
Entity Type:Individual
Prefix:
First Name:SAVAN
Middle Name:MUKESH
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 W 87TH ST APT 5
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-1045
Mailing Address - Country:US
Mailing Address - Phone:214-929-1983
Mailing Address - Fax:
Practice Address - Street 1:14701 PULASKI RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:IL
Practice Address - Zip Code:60445-3410
Practice Address - Country:US
Practice Address - Phone:708-239-2150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051305096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist