Individual
PATRICIA VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1901 W HARRISON ST, CLINIC E, CHICAGO, IL 60612-3714
(312) 864-7776
(312) 864-9542
Mailing address
1900 W POLK ST, SUITE 465, CHICAGO, IL 60612-3723
(312) 864-5215
(312) 864-9542
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036091143
IL
Other
Enumeration date
03/27/2007
Last updated
05/04/2021
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