Provider Demographics
NPI:1922034164
Name:WOODFIELD PHYSICAL MEDICINE
Entity Type:Organization
Organization Name:WOODFIELD PHYSICAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-932-1076
Mailing Address - Street 1:1111 PLAZA DR
Mailing Address - Street 2:SUITE 325
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60713-4901
Mailing Address - Country:US
Mailing Address - Phone:847-932-1079
Mailing Address - Fax:847-932-1082
Practice Address - Street 1:1111 N PLAZA DR
Practice Address - Street 2:SUITE 325
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-6021
Practice Address - Country:US
Practice Address - Phone:847-932-1079
Practice Address - Fax:847-932-1082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210772Medicare ID - Type Unspecified