Provider Demographics
NPI:1568183218
Name:PATEL, TANVI (PA-C)
Entity type:Individual
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First Name:TANVI
Middle Name:
Last Name:PATEL
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Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:10350 HALIGUS RD STE C
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-9545
Mailing Address - Country:US
Mailing Address - Phone:312-695-3800
Mailing Address - Fax:815-455-2789
Practice Address - Street 1:10350 HALIGUS RD STE C
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9545
Practice Address - Country:US
Practice Address - Phone:312-695-3800
Practice Address - Fax:815-455-2789
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL085010100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant