Individual
PRIANCA PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
550 E DEVON AVE STE 200, ITASCA, IL 60143-2639
(864) 625-3376
Mailing address
550 E DEVON AVE STE 200, ITASCA, IL 60143-2639
(864) 625-3376
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007790
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
03/25/2020
Last updated
06/30/2020
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