Provider Demographics
NPI:1992010516
Name:PATEL, YAYATI S (DO)
Entity Type:Individual
Prefix:
First Name:YAYATI
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 95TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-7802
Mailing Address - Country:US
Mailing Address - Phone:630-646-6920
Mailing Address - Fax:630-646-6925
Practice Address - Street 1:2007 95TH ST STE 105
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-7802
Practice Address - Country:US
Practice Address - Phone:630-646-6920
Practice Address - Fax:630-646-6925
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036131839207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine