Individual
PUJA PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4663 W 95TH ST, OAK LAWN, IL 60453-2540
(708) 636-0600
(708) 636-0606
Mailing address
2106 N FROLIC AVE, WAUKEGAN, IL 60087-3592
(847) 338-7028
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
46011605
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/04/2021
Last updated
06/20/2024
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