Individual
DISHA PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17800 KEDZIE AVE, HAZEL CREST, IL 60429-2029
(708) 213-3829
Mailing address
3703 W LAKE AVE, GLENVIEW, IL 60026-5823
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070020488
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070020488
—
IL
Enumeration date
01/06/2014
Last updated
01/06/2014
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