Provider Demographics
NPI:1679455505
Name:RAJUL PATEL WEST LOOP PC
Entity type:Organization
Organization Name:RAJUL PATEL WEST LOOP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:BLEDSOE
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-580-0028
Mailing Address - Street 1:107 W LAKE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1027
Mailing Address - Country:US
Mailing Address - Phone:630-307-3133
Mailing Address - Fax:630-307-3134
Practice Address - Street 1:1755 W NORTH AVE STE C-101
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-5450
Practice Address - Country:US
Practice Address - Phone:773-527-2790
Practice Address - Fax:630-307-3134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty