Doctor Name: | IMARI PARESH PATEL |
NPI Number: | 1366822975 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DO |
License Number: | 125067373 |
Business Practice Address: | 5201 Willow Springs Rd 2nd Floor La Grange Highlands, IL - 605256537 |
Business Phone Number: | 7082458900 |
Business Fax Number: | 7082455604 |
Mailing Address: | 5201 Willow Springs Rd, 2nd Floor LA GRANGE HIGHLANDS |
State: | IL |
Postal Code: | 605256537 |
Phone Number: | 7082458900 |
Fax Number: | 7082455604 |
NPI Enumeration Date: | 06/09/2015 |
NPI Last Update Date: | 06/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 125067373 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |