Provider Demographics
NPI:1992553374
Name:PATEL, KINJAL R (APRN)
Entity type:Individual
Prefix:
First Name:KINJAL
Middle Name:R
Last Name:PATEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 E WOODFIELD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4776
Mailing Address - Country:US
Mailing Address - Phone:847-605-8700
Mailing Address - Fax:847-605-8700
Practice Address - Street 1:804 E WOODFIELD RD STE 300
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4776
Practice Address - Country:US
Practice Address - Phone:847-605-8700
Practice Address - Fax:847-605-8700
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209030140363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner