Provider Demographics
NPI:1639693237
Name:PATEL, HARSHIL V (DMD)
Entity Type:Individual
Prefix:DR
First Name:HARSHIL
Middle Name:V
Last Name:PATEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 DEMPSTER ST APT 310
Mailing Address - Street 2:
Mailing Address - City:MT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4943
Mailing Address - Country:US
Mailing Address - Phone:224-345-1332
Mailing Address - Fax:
Practice Address - Street 1:727 RIDGEVIEW DR
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-7054
Practice Address - Country:US
Practice Address - Phone:815-847-9292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019031282122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist