Individual
FAIRY PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2324 W WAR MEMORIAL DR, PEORIA, IL 61614-5552
(309) 685-5209
Mailing address
2324 W WAR MEMORIAL DRIVE, PEORIA, IL 61614-5552
(309) 685-5209
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051300537
IL
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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