Provider Demographics
NPI:1649590878
Name:PATEL, MEHUL ARVIND (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MEHUL
Middle Name:ARVIND
Last Name:PATEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 ELISHA AVE
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099
Mailing Address - Country:US
Mailing Address - Phone:847-872-4561
Mailing Address - Fax:
Practice Address - Street 1:2361 PAYSPHERE CIR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60674
Practice Address - Country:US
Practice Address - Phone:847-746-4358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
IL085.003772363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical