Provider Demographics
NPI:1427549393
Name:PATEL, DEVIKA R
Entity type:Individual
Prefix:
First Name:DEVIKA
Middle Name:R
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 BARRINGTON RD STE 400
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2036
Mailing Address - Country:US
Mailing Address - Phone:815-947-4463
Mailing Address - Fax:815-597-4463
Practice Address - Street 1:2300 BARRINGTON RD STE 400
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2036
Practice Address - Country:US
Practice Address - Phone:815-947-4463
Practice Address - Fax:815-597-4463
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-25
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209017723363L00000X
IL277001397363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner