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Organization

KETAN R PATEL

Active
Other names
ketan r patel
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KETAN R PATEL MD (SELF EMPLOYED)
(815) 872-1221
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036083069
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036083069
IL
01
1114910528
NPI
IL
Enumeration date
08/18/2014
Last updated
08/18/2014
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