Provider Demographics
NPI:1174758163
Name:PATEL, SAMIR K (MD)
Entity type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:K
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 1:251 E HURON STREET, F5-704
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-472-3585
Mailing Address - Fax:312-472-3590
Practice Address - Street 1:251 E HURON STREET, F5-704
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-472-3585
Practice Address - Fax:312-472-3590
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1 - 0034752207L00000X
IL036133094207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology