Provider Demographics
NPI:1710112263
Name:PATEL, NISHA V (MD)
Entity Type:Individual
Prefix:DR
First Name:NISHA
Middle Name:V
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NISHA
Other - Middle Name:
Other - Last Name:GOYAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1640 N ARLINGTON HEIGHTS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-3985
Mailing Address - Country:US
Mailing Address - Phone:847-567-7425
Mailing Address - Fax:847-506-8927
Practice Address - Street 1:1640 N ARLINGTON HEIGHTS RD STE 101
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3985
Practice Address - Country:US
Practice Address - Phone:847-567-7425
Practice Address - Fax:847-506-8927
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36.124169207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine