Provider Demographics
NPI:1508811555
Name:PATEL, NATVARLAL P (MD)
Entity Type:Individual
Prefix:DR
First Name:NATVARLAL
Middle Name:P
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 1:350 MAYO LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-8807
Mailing Address - Country:US
Mailing Address - Phone:630-307-0151
Mailing Address - Fax:
Practice Address - Street 1:743 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-4059
Practice Address - Country:US
Practice Address - Phone:773-533-3553
Practice Address - Fax:773-533-3554
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL760680Medicare ID - Type Unspecified
ILD16250Medicare UPIN