Individual
KRISHAN I PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 422-6100
(217) 422-7897
Mailing address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 422-6100
(217) 422-7897
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036-050324
IL
207RC0000X
Cardiovascular Disease Physician
Primary
036050324
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036050324
—
IL
01
—
060041659
RAILROAD
IL
Enumeration date
10/19/2006
Last updated
12/03/2012
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