Provider Demographics
NPI:1831353135
Name:PATEL, JIGNASA
Entity type:Individual
Prefix:
First Name:JIGNASA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 CASTLE ROCK CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-8414
Mailing Address - Country:US
Mailing Address - Phone:630-386-5247
Mailing Address - Fax:
Practice Address - Street 1:4200 CASTLE ROCK CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-8414
Practice Address - Country:US
Practice Address - Phone:708-473-9215
Practice Address - Fax:708-786-4490
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.040773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist