Provider Demographics
NPI:1710668769
Name:RAJUL PATEL WESTLOOP PC
Entity Type:Organization
Organization Name:RAJUL PATEL WESTLOOP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAJUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-968-6636
Mailing Address - Street 1:1007 W WELLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4325
Mailing Address - Country:US
Mailing Address - Phone:773-598-6262
Mailing Address - Fax:
Practice Address - Street 1:1007 W WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4325
Practice Address - Country:US
Practice Address - Phone:773-598-6262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAJUL PATEL WESTLOOP PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty