Provider Demographics
NPI:1710932264
Name:PATEL, AASITA NITIN (MD)
Entity Type:Individual
Prefix:
First Name:AASITA
Middle Name:NITIN
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7035 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1015
Mailing Address - Country:US
Mailing Address - Phone:708-680-3800
Mailing Address - Fax:708-383-3665
Practice Address - Street 1:804 E WOODFIELD RD
Practice Address - Street 2:SUITE 300
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4714
Practice Address - Country:US
Practice Address - Phone:847-605-0030
Practice Address - Fax:847-637-0737
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036114323207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036114323Medicaid
ILIL1648003Medicare PIN