Provider Demographics
NPI:1972288934
Name:PATEL, HITEN NITIN (DMD)
Entity type:Individual
Prefix:
First Name:HITEN
Middle Name:NITIN
Last Name:PATEL
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 W SUPERIOR ST APT 3716
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-8849
Mailing Address - Country:US
Mailing Address - Phone:334-343-0554
Mailing Address - Fax:
Practice Address - Street 1:4641 W DIVERSEY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-1828
Practice Address - Country:US
Practice Address - Phone:773-692-4147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.035521122300000X
MADN1860028122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist