Provider Demographics
NPI:1205981750
Name:PATEL, CHIRAG (MD)
Entity type:Individual
Prefix:
First Name:CHIRAG
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 E 86TH AVE
Mailing Address - Street 2:SUITE Z
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6173
Mailing Address - Country:US
Mailing Address - Phone:219-769-0777
Mailing Address - Fax:219-755-0612
Practice Address - Street 1:521 E 86TH AVE
Practice Address - Street 2:SUITE Z
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6173
Practice Address - Country:US
Practice Address - Phone:219-769-0777
Practice Address - Fax:219-755-0612
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01052839A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
251203OtherANTHEM
497970OMedicare ID - Type Unspecified
251203OtherANTHEM