Provider Demographics
NPI:1528287620
Name:PATEL, ANKITA (MD)
Entity type:Individual
Prefix:
First Name:ANKITA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3880 SALEM LAKE DR STE F
Mailing Address - Street 2:
Mailing Address - City:LONG GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60047-5292
Mailing Address - Country:US
Mailing Address - Phone:847-719-2220
Mailing Address - Fax:847-719-2265
Practice Address - Street 1:22285 N PEPPER RD STE 302
Practice Address - Street 2:
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2541
Practice Address - Country:US
Practice Address - Phone:847-726-0774
Practice Address - Fax:847-277-1549
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2024-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036116607207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036116607OtherILLINOIS LICENSE
FP0286763OtherDEA