Provider Demographics
NPI:1760703599
Name:PATEL, DIPALI J (DC)
Entity Type:Individual
Prefix:DR
First Name:DIPALI
Middle Name:J
Last Name:PATEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DIPALI
Other - Middle Name:J
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:7315 CUMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-2616
Mailing Address - Country:US
Mailing Address - Phone:630-830-2060
Mailing Address - Fax:
Practice Address - Street 1:7315 CUMBERLAND DR
Practice Address - Street 2:
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-2616
Practice Address - Country:US
Practice Address - Phone:630-830-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10103111N00000X
IL038011631111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400154590Medicare UPIN