Provider Demographics
NPI:1134627201
Name:PATEL, RESHA (NP)
Entity type:Individual
Prefix:
First Name:RESHA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 FEEHANVILLE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-6036
Mailing Address - Country:US
Mailing Address - Phone:847-823-3185
Mailing Address - Fax:847-823-3318
Practice Address - Street 1:1660 FEEHANVILLE DR STE 200
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-6036
Practice Address - Country:US
Practice Address - Phone:847-823-3185
Practice Address - Fax:847-823-3318
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277002418363LF0000X, 363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily