Individual
NISHANT PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
4401 W LAWRENCE AVE, CHICAGO, IL 60630-2510
(773) 725-6086
Mailing address
965 PIMLICO LN, BARTLETT, IL 60103-2073
(630) 776-1432
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.028279
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021002461
IL
Other
Enumeration date
08/07/2012
Last updated
08/09/2012
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