Provider Demographics
NPI:1154526770
Name:PATEL, DAKSESH BIPIN (DO)
Entity type:Individual
Prefix:DR
First Name:DAKSESH
Middle Name:BIPIN
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 AUSTIN STREET
Mailing Address - Street 2:WEST TOWER, SUITE 403
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3444
Mailing Address - Country:US
Mailing Address - Phone:847-491-9020
Mailing Address - Fax:847-491-0182
Practice Address - Street 1:800 AUSTIN ST STE 403
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3444
Practice Address - Country:US
Practice Address - Phone:847-491-9020
Practice Address - Fax:847-491-0182
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-126175207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
399980OtherGROUP MEDICARE PTAN
PA23-2290323Medicare UPIN