Provider Demographics
NPI:1194914341
Name:PATEL, RIPPLE (PT)
Entity type:Individual
Prefix:
First Name:RIPPLE
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3900 W 95TH ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-1922
Mailing Address - Country:US
Mailing Address - Phone:708-423-7799
Mailing Address - Fax:708-423-7791
Practice Address - Street 1:473 W ARMY TRAIL RD
Practice Address - Street 2:SUITE 103
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2674
Practice Address - Country:US
Practice Address - Phone:630-295-9900
Practice Address - Fax:630-295-9909
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL070016059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist