Provider Demographics
NPI:1427505783
Name:PATEL, SUNIL D (PHARMACIST)
Entity type:Individual
Prefix:
First Name:SUNIL
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6429
Mailing Address - Country:US
Mailing Address - Phone:815-744-7601
Mailing Address - Fax:815-744-7605
Practice Address - Street 1:2424 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6429
Practice Address - Country:US
Practice Address - Phone:815-744-7601
Practice Address - Fax:815-744-7605
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-04
Last Update Date:2016-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-287152183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist