Individual
PRITI M. PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
530 NE GLENOAK AVE, PEORIA, IL 61603-3133
(319) 354-1625
Mailing address
530 NE GLENOAK AVE, PEORIA, IL 61603-3133
(319) 354-1625
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
36156
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216946
MEDICARE GROUP PTAN
IL
Enumeration date
06/07/2007
Last updated
07/05/2022
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