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Individual

AMBALAL K PATEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1423 CHICAGO RD, CHICAGO HEIGHTS, IL 60411-3400
(708) 755-3348
Mailing address
1922 HANOVER LN, FLOSSMOOR, IL 60422-1926
(708) 957-0634

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1619159
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/27/2006
Last updated
07/08/2007
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