Provider Demographics
NPI:1659524213
Name:PATEL, AMISH M (MD)
Entity Type:Individual
Prefix:DR
First Name:AMISH
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1365 WILEY ROAD
Mailing Address - Street 2:SUITE 153
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4357
Mailing Address - Country:US
Mailing Address - Phone:847-519-4701
Mailing Address - Fax:847-519-4707
Practice Address - Street 1:1365 WILEY ROAD
Practice Address - Street 2:SUITE 153
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4357
Practice Address - Country:US
Practice Address - Phone:847-519-4701
Practice Address - Fax:847-519-4707
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036120841207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036120841Medicaid
IL217074002Medicare PIN
IL217075002Medicare PIN