Provider Demographics
NPI:1962689117
Name:PATEL, PURVI DHAVAL (MD)
Entity Type:Individual
Prefix:
First Name:PURVI
Middle Name:DHAVAL
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PURVIBEN
Other - Middle Name:DHAVAL
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9550 W 167TH ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5561
Mailing Address - Country:US
Mailing Address - Phone:708-873-4500
Mailing Address - Fax:708-873-4531
Practice Address - Street 1:9550 W 167TH ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5561
Practice Address - Country:US
Practice Address - Phone:708-873-4500
Practice Address - Fax:708-873-4531
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2021-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-119578207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine