Provider Demographics
NPI:1023157260
Name:PATEL, RAJAN H (MD)
Entity type:Individual
Prefix:
First Name:RAJAN
Middle Name:H
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9301 GOLF RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1667
Mailing Address - Country:US
Mailing Address - Phone:847-296-8151
Mailing Address - Fax:847-296-3915
Practice Address - Street 1:9301 GOLF RD
Practice Address - Street 2:SUITE 302
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1667
Practice Address - Country:US
Practice Address - Phone:847-296-8151
Practice Address - Fax:847-296-3915
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036105452207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH78140Medicare UPIN
204620Medicare ID - Type Unspecified