Provider Demographics
NPI:1548371982
Name:PATEL, RITESH (MD)
Entity type:Individual
Prefix:DR
First Name:RITESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E WOODFIELD RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4717
Mailing Address - Country:US
Mailing Address - Phone:847-995-9500
Mailing Address - Fax:847-995-9501
Practice Address - Street 1:800 E WOODFIELD RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4717
Practice Address - Country:US
Practice Address - Phone:847-995-9500
Practice Address - Fax:847-995-9501
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-115260207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036115260Medicaid
ILK51544OtherMEDICARE PTAN
ILIL4207001Medicare PIN
ILIL2670001Medicare PIN
IL036115260Medicaid
ILIL2564001Medicare PIN
ILF400151984Medicare PIN