Individual
AMIT D PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19550 GOVERNORS HWY, SUITE 2000, FLOSSMOOR, IL 60422-2125
(708) 957-8750
(708) 957-8602
Mailing address
27702 NETWORK PL, CHICAGO, IL 60673-1277
(708) 862-7674
(708) 862-1781
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036133822
IL
390200000X
Student in an Organized Health Care Education/Training Program
125060430
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036133822
—
IL
01
—
F400436605
MEDICARE
IL
01
—
P01953160
RRM
IL
Enumeration date
06/23/2011
Last updated
12/19/2018
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