Provider Demographics
NPI:1831795384
Name:PATEL, NEHAL (PHARMD)
Entity type:Individual
Prefix:
First Name:NEHAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16760 W DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-4601
Mailing Address - Country:US
Mailing Address - Phone:815-834-4290
Mailing Address - Fax:
Practice Address - Street 1:16760 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-4601
Practice Address - Country:US
Practice Address - Phone:815-834-4290
Practice Address - Fax:815-834-4296
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051290779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist