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Individual

DR. VAISHALI M PATEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
900 MAIN ST, PEORIA, IL 61602-1005
(309) 282-9676
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036154797
IL
208600000X
Surgery Physician
2018043034
MO
208600000X
Surgery Physician
5101020122
MI

Other

Enumeration date
07/02/2012
Last updated
04/19/2023
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