# KETAN R PATEL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ketan r patel
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114326956
- **Authorized official:** DR. KETAN R PATEL MD (SELF EMPLOYED)
- **Authorized official phone:** (815) 872-1221

## Contact information

- **Practice address:** 530 PARK AVE E, SUITE 101, PRINCETON, IL 61356-3901
- **Practice address phone:** (815) 872-1221
- **Practice address fax:** (815) 872-2304
- **Mailing address:** 530 PARK AVE E, SUITE 101, PRINCETON, IL 61356-3901
- **Mailing address phone:** (815) 872-1221
- **Mailing address fax:** (815) 872-2304

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 036083069 | IL | Yes |

## Other

- **Enumeration date:** 08/18/2014
- **Last updated:** 08/18/2014