Individual
DR. NIRMAL PATODIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 SUPERIOR STREET, SUITE 206, MELROSE PARK, IL 60160
(708) 338-9388
(708) 388-9389
Mailing address
1111 SUPERIOR STREET, SUITE 206, MELROSE PARK, IL 60160
(708) 338-9388
(708) 388-9389
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036053904
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053904
—
IL
01
—
060068384
RRM
—
01
—
21609006
BCBS
—
Enumeration date
07/05/2006
Last updated
09/16/2011
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