Provider Demographics
NPI:1861606287
Name:PATEL, MITESH D (PHARMD)
Entity type:Individual
Prefix:
First Name:MITESH
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 CEDAR TREE CT
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60194-1644
Mailing Address - Country:US
Mailing Address - Phone:847-912-3201
Mailing Address - Fax:847-803-2022
Practice Address - Street 1:369 CEDAR TREE CT
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60194-1644
Practice Address - Country:US
Practice Address - Phone:847-912-3201
Practice Address - Fax:847-803-2022
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist