Provider Demographics
NPI:1316288517
Name:PATEL, PARAGKUMAR C (MD)
Entity type:Individual
Prefix:DR
First Name:PARAGKUMAR
Middle Name:C
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 CARPENTER ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62769-5556
Mailing Address - Country:US
Mailing Address - Phone:217-544-6464
Mailing Address - Fax:214-525-5673
Practice Address - Street 1:800 E CARPENTER ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62769-3413
Practice Address - Country:US
Practice Address - Phone:217-544-6464
Practice Address - Fax:214-525-5673
Is Sole Proprietor?:No
Enumeration Date:2013-03-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020036098207R00000X
IL036167182207R00000X, 207RC0200X
OK32065207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine