Provider Demographics
NPI:1720287378
Name:PATEL, ALPESH M (MD)
Entity Type:Individual
Prefix:
First Name:ALPESH
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1075N GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-2244
Mailing Address - Country:US
Mailing Address - Phone:941-315-6194
Mailing Address - Fax:941-209-5322
Practice Address - Street 1:1075N GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-2244
Practice Address - Country:US
Practice Address - Phone:847-782-7120
Practice Address - Fax:847-782-7140
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036126334207Q00000X
MI4301089614207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine