Provider Demographics
NPI:1598704199
Name:PATEL, JESAL S (MD)
Entity Type:Individual
Prefix:DR
First Name:JESAL
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:150 N RIVER RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1272
Mailing Address - Country:US
Mailing Address - Phone:847-391-9944
Mailing Address - Fax:847-391-9955
Practice Address - Street 1:150 N RIVER RD
Practice Address - Street 2:SUITE 220
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1272
Practice Address - Country:US
Practice Address - Phone:847-391-9944
Practice Address - Fax:847-391-9955
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H22218Medicare UPIN
IL572740Medicare ID - Type Unspecified