Individual
SHRUTI PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1044 N MOZART ST STE 405, CHICAGO, IL 60622-2790
(773) 423-6400
(773) 423-8440
Mailing address
1044 N MOZART ST STE 405, CHICAGO, IL 60622-2790
(773) 423-6400
(773) 423-8440
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.011170
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.011170
LICENSE
IL
Enumeration date
05/20/2014
Last updated
02/18/2016
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