Provider Demographics
NPI:1528581451
Name:PATEL, RAHUL H
Entity Type:Individual
Prefix:
First Name:RAHUL
Middle Name:H
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2953 KELLY DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124-4349
Mailing Address - Country:US
Mailing Address - Phone:630-673-5527
Mailing Address - Fax:
Practice Address - Street 1:1100 S RANDALL RD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4109
Practice Address - Country:US
Practice Address - Phone:847-468-9696
Practice Address - Fax:847-468-8077
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-23
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051302723183500000X
IL049214217183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No183700000XPharmacy Service ProvidersPharmacy Technician