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Individual

DR. JASHBHAI M PATEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
30 E 15TH ST, SUITE 202, CHICAGO HEIGHTS, IL 60411-3459
(708) 754-7777
(708) 754-7701
Mailing address
30 E 15TH ST, SUITE 202, CHICAGO HEIGHTS, IL 60411-3459
(708) 754-7777
(708) 754-7701

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
036-050323
IL
207Q00000X
Family Medicine Physician
Primary
036050323
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01623866
BLUECROSS BLUESHIELD
IL
05
036-050323
IL
01
080165392
MEDICARE RAILROAD
IL
01
F400196012
MEDICARE PTAN
IL
Enumeration date
11/16/2006
Last updated
09/29/2015
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