Individual
POOJA DAVE PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1809 W CHICAGO AVE # 5, CHICAGO, IL 60622-5677
(630) 709-7818
Mailing address
812 W VAN BUREN ST APT 4D, CHICAGO, IL 60607-3535
(630) 709-7818
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209011185
IL
363LF0000X
Family Nurse Practitioner
209011185
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
277.001241
277.001241
IL
Enumeration date
06/06/2012
Last updated
12/26/2022
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