Provider Demographics
NPI:1588830129
Name:PATEL, JAYSHIL J (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYSHIL
Middle Name:J
Last Name:PATEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:10000 W INNOVATION DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4837
Mailing Address - Country:US
Mailing Address - Phone:414-456-5006
Mailing Address - Fax:414-456-6259
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DIVISION OF PULMONARY MEDICINE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6633
Practice Address - Fax:414-955-6211
Is Sole Proprietor?:No
Enumeration Date:2008-05-04
Last Update Date:2011-06-23
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Provider Licenses
StateLicense IDTaxonomies
IL125050318207R00000X
WI53304207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1588830129Medicaid