Individual
NISHA K. PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2077 N CLYBOURN AVE, CHICAGO, IL 60614-4003
(773) 886-1500
(773) 935-5367
Mailing address
9701 W HIGGINS RD STE 270, ROSEMONT, IL 60018-4703
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PA1777
TN
363A00000X
Physician Assistant
Primary
085004302
IL
363A00000X
Physician Assistant
PA1777
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1516453
—
TN
Enumeration date
10/07/2009
Last updated
01/14/2020
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