Provider Demographics
NPI:1609427137
Name:PATEL, PRINA (APN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:PRINA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 FLETCHER DR STE 202
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4749
Mailing Address - Country:US
Mailing Address - Phone:847-888-1300
Mailing Address - Fax:
Practice Address - Street 1:745 FLETCHER DR STE 202
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4749
Practice Address - Country:US
Practice Address - Phone:847-888-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019930363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner