Provider Demographics
NPI:1497375687
Name:PATEL, VIVEK B (MD)
Entity type:Individual
Prefix:DR
First Name:VIVEK
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:611 W PARK ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-2501
Practice Address - Country:US
Practice Address - Phone:217-383-3129
Practice Address - Fax:217-326-1550
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-17
Last Update Date:2025-02-10
Deactivation Date:2024-03-25
Deactivation Code:
Reactivation Date:2024-04-02
Provider Licenses
StateLicense IDTaxonomies
PAMD483527208M00000X
IL036173071207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist