Provider Demographics
NPI:1497550388
Name:PATEL, SANJANA P (FNP)
Entity type:Individual
Prefix:
First Name:SANJANA
Middle Name:P
Last Name:PATEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 WELLINGTON AVE UNIT 114
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3356
Mailing Address - Country:US
Mailing Address - Phone:224-436-0751
Mailing Address - Fax:
Practice Address - Street 1:700 WELLINGTON AVE UNIT 114
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3356
Practice Address - Country:US
Practice Address - Phone:224-436-0751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209031523363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily