Provider Demographics
NPI:1174549943
Name:ARVIND PATEL M.D.S.C.
Entity type:Organization
Organization Name:ARVIND PATEL M.D.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARVIND
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-299-6400
Mailing Address - Street 1:380 E NORTHWEST HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2274
Mailing Address - Country:US
Mailing Address - Phone:847-813-0700
Mailing Address - Fax:
Practice Address - Street 1:380 E NORTHWEST HWY STE 200
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2274
Practice Address - Country:US
Practice Address - Phone:847-813-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036053174208600000X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036053174Medicaid
ILCH9420OtherRR MEDICARE
IL31600344OtherBLUE CROSS
IL31600344OtherBLUE CROSS
ILCH9420OtherRR MEDICARE
ILD14653Medicare UPIN