Provider Demographics
NPI:1740298231
Name:PATEL, RASHMIKANT SHANTILAL (MD)
Entity type:Individual
Prefix:MR
First Name:RASHMIKANT
Middle Name:SHANTILAL
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 1:20 TOWER COURT
Mailing Address - Street 2:STE D
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031
Mailing Address - Country:US
Mailing Address - Phone:847-336-6550
Mailing Address - Fax:847-336-6595
Practice Address - Street 1:20 TOWER COURT
Practice Address - Street 2:STE D
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031
Practice Address - Country:US
Practice Address - Phone:847-336-6550
Practice Address - Fax:847-336-6595
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04901153OtherBLUE CROSS BLUE SHIELD
IL951831Medicare ID - Type Unspecified
IL04901153OtherBLUE CROSS BLUE SHIELD
E93823Medicare UPIN