Provider Demographics
NPI:1467403535
Name:PATEL, NALIN M (MD)
Entity Type:Individual
Prefix:DR
First Name:NALIN
Middle Name:M
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 1:23 BREEZES
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620
Mailing Address - Country:US
Mailing Address - Phone:217-840-5183
Mailing Address - Fax:217-352-2891
Practice Address - Street 1:410 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-3827
Practice Address - Country:US
Practice Address - Phone:217-352-2881
Practice Address - Fax:217-352-2891
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036056221207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036056221Medicaid
IL649520Medicare ID - Type Unspecified
IL036056221Medicaid