Individual
NISHA UTPAL PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(815) 557-7177
Mailing address
13338 KERR ST, PLAINFIELD, IL 60585-1690
(815) 557-7177
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
CA-DEN
IL
Other
Enumeration date
05/15/2020
Last updated
05/15/2020
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