Provider Demographics
NPI:1245830884
Name:PATEL, SATISH K (PHARMACIST)
Entity type:Individual
Prefix:
First Name:SATISH
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1937 TOWNER LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-2153
Mailing Address - Country:US
Mailing Address - Phone:630-400-0748
Mailing Address - Fax:
Practice Address - Street 1:101 W OAKTON ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-1834
Practice Address - Country:US
Practice Address - Phone:847-296-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-039587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist