| Doctor Name: | VIVEK PATEL |
| NPI Number: | 1194165357 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 016005710 |
| Business Practice Address: | 401 E 162nd St Suite 101 South Holland, IL - 604732236 |
| Business Phone Number: | 7085963757 |
| Business Fax Number: | |
| Mailing Address: | 401 E 162nd St, Suite 101 SOUTH HOLLAND |
| State: | IL |
| Postal Code: | 604732236 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/02/2013 |
| NPI Last Update Date: | 06/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 016005710 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |