Provider Demographics
NPI:1639772221
Name:PATEL, AMIT (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 STRATFORD RD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2003
Mailing Address - Country:US
Mailing Address - Phone:847-644-1544
Mailing Address - Fax:
Practice Address - Street 1:69 W WASHINGTON ST LOWR LL09
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3136
Practice Address - Country:US
Practice Address - Phone:312-629-1621
Practice Address - Fax:312-629-1690
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051289468183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist