Provider Demographics
NPI:1518154624
Name:PATEL, SHAILEE SHASHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAILEE
Middle Name:SHASHI
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 BRINTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021
Mailing Address - Country:US
Mailing Address - Phone:815-288-4731
Mailing Address - Fax:815-288-1419
Practice Address - Street 1:724 BRINTON AVENUE
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021
Practice Address - Country:US
Practice Address - Phone:815-288-4731
Practice Address - Fax:815-288-1419
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0274151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice