Individual
KETAN PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 PARK AVE E, STE 101, PRINCETON, IL 61356-3901
(815) 872-1221
(815) 872-2304
Mailing address
530 PARK AVE E, STE 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
Enumeration date
08/31/2005
Last updated
10/15/2020
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