Organization
KETAN R PATEL
Active
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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