Provider Demographics
NPI:1689353005
Name:PATEL, RAHUL RAMESHBHAI (PT DPT)
Entity Type:Individual
Prefix:
First Name:RAHUL
Middle Name:RAMESHBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 DES PLAINES AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-2130
Mailing Address - Country:US
Mailing Address - Phone:731-607-7747
Mailing Address - Fax:
Practice Address - Street 1:12 SALT CREEK LN STE 325
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-8621
Practice Address - Country:US
Practice Address - Phone:630-856-6425
Practice Address - Fax:630-856-9425
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.027076225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist