Provider Demographics
NPI:1437387412
Name:PATEL, NAITIK (MD)
Entity Type:Individual
Prefix:
First Name:NAITIK
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 W 22ND ST
Mailing Address - Street 2:SUITE 610
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2006
Mailing Address - Country:US
Mailing Address - Phone:630-537-1720
Mailing Address - Fax:773-326-3518
Practice Address - Street 1:1301 W 22ND ST
Practice Address - Street 2:SUITE 610
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-2006
Practice Address - Country:US
Practice Address - Phone:630-537-1720
Practice Address - Fax:773-326-3518
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036132421207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1437387412Medicaid
IL1437387412Medicare NSC
IL1437387412Medicare PIN
IL1437387412Medicaid
IL1437387412Medicare UPIN