Provider Demographics
NPI:1518579739
Name:PATEL, RIZWANA (APN-CNP)
Entity Type:Individual
Prefix:
First Name:RIZWANA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6810 N MCCORMICK BLVD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-2709
Mailing Address - Country:US
Mailing Address - Phone:847-674-6900
Mailing Address - Fax:
Practice Address - Street 1:6810 N MCCORMICK BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712
Practice Address - Country:US
Practice Address - Phone:847-674-6900
Practice Address - Fax:847-329-4728
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021900363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner