Provider Demographics
NPI:1316111388
Name:RASHMIKANT S.PATEL M.D.S.C.
Entity type:Organization
Organization Name:RASHMIKANT S.PATEL M.D.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHMIKANT
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-336-6550
Mailing Address - Street 1:20 TOWER CT
Mailing Address - Street 2:SUITE D
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5711
Mailing Address - Country:US
Mailing Address - Phone:847-336-6550
Mailing Address - Fax:
Practice Address - Street 1:20 TOWER CT
Practice Address - Street 2:SUITE D
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5711
Practice Address - Country:US
Practice Address - Phone:847-336-6550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-21
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036079486261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04901153OtherBLUE CROSS BLUE SHIELD
IL951830OtherMEDICARE PROVIDER NUMBER ,GURNEE
IL951831OtherMEDICARE PROVIDER NUMBER,LINDENHURST
IL036079486Medicaid
ILE93823OtherUPIN