Provider Demographics
NPI:1205114097
Name:PATEL, NEELON CHIRAG (DDS, MS)
Entity type:Individual
Prefix:
First Name:NEELON
Middle Name:CHIRAG
Last Name:PATEL
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 ALTA VISTA CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1844
Mailing Address - Country:US
Mailing Address - Phone:248-212-3212
Mailing Address - Fax:
Practice Address - Street 1:1355 E. OGDEN AVE
Practice Address - Street 2:#105
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563
Practice Address - Country:US
Practice Address - Phone:630-687-9292
Practice Address - Fax:630-687-9292
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103420122300000X, 1223P0221X
MI29010203751223G0001X
IL019.0293631223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice