Individual
SHAWN PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12203 CORPORATE PKWY, MEQUON, WI 53092-3388
(262) 387-8200
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
101708-875
WI
207Q00000X
Family Medicine Physician
125.073287
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100284348
—
WI
Enumeration date
06/22/2018
Last updated
08/08/2024
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