Provider Demographics
NPI:1255709721
Name:PATEL, NICK (PA-C)
Entity type:Individual
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First Name:NICK
Middle Name:
Last Name:PATEL
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:10719 160TH ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5541
Mailing Address - Country:US
Mailing Address - Phone:708-226-3300
Mailing Address - Fax:708-226-3500
Practice Address - Street 1:10719 160TH ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5541
Practice Address - Country:US
Practice Address - Phone:708-226-3300
Practice Address - Fax:708-226-3500
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2022-01-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical