Provider Demographics
NPI:1538445770
Name:PATEL, PARESH (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:PARESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CARLYLE LN
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6697
Mailing Address - Country:US
Mailing Address - Phone:847-478-0579
Mailing Address - Fax:
Practice Address - Street 1:1770 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-1317
Practice Address - Country:US
Practice Address - Phone:847-327-9706
Practice Address - Fax:847-327-9710
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051038075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist