Provider Demographics
NPI:1477600252
Name:PATEL, VIRAY LALIT (DDS)
Entity Type:Individual
Prefix:
First Name:VIRAY
Middle Name:LALIT
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N WESTSHORE DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7207
Mailing Address - Country:US
Mailing Address - Phone:402-319-9270
Mailing Address - Fax:
Practice Address - Street 1:16533 W 159TH ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-7900
Practice Address - Country:US
Practice Address - Phone:815-836-3700
Practice Address - Fax:815-836-3701
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223G0001XDental ProvidersDentistGeneral Practice