Individual
DR. SAMIR A PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1730 E LAKE SHORE DR, DECATUR, IL 62521-3809
(217) 329-1000
(217) 329-1055
Mailing address
1900 E LAKE SHORE DR, SUITE 330, DECATUR, IL 62521-3824
(217) 423-2889
(217) 423-2923
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036096741
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094812
—
IL
Enumeration date
07/19/2005
Last updated
12/30/2021
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