Individual
DHAVAL M PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
698 FEATHERSTONE RD, ROCKFORD, IL 61107-6303
(815) 398-3277
(815) 986-1448
Mailing address
698 FEATHERSTONE RD, ROCKFORD, IL 61107-6303
(815) 398-3277
(815) 986-1448
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
336.078808
IL
2086S0122X
Plastic and Reconstructive Surgery Physician
49831
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036117242
—
IL
05
—
35294600
—
WI
05
—
473965000
—
MN
05
—
ENROLLED
—
IA
01
—
F400199319
MEDICARE INDIVIDUAL
IL
01
—
IL6310
MEDICARE GROUP
IL
Enumeration date
02/16/2007
Last updated
07/21/2022
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