Individual
HETALKUMAR PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
5TH AVENUE AND ROOSEVELT ROAD, BLDG 37 NW, HINES, IL 60141
(770) 554-3545
(708) 786-4490
Mailing address
4112 VICTORIA AVE, MOUNT VERNON, IL 62864-7022
(917) 698-4933
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051294793
IL
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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