Individual
SHREYA PATEL-PATHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
623 HOLIDAY LN, HAINESVILLE, IL 60073-4702
(111) 111-1111
Mailing address
623 HOLIDAY LN, HAINESVILLE, IL 60073-4702
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041545286
IL
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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