Provider Demographics
NPI:1871071431
Name:PATEL, HITEKSHA
Entity type:Individual
Prefix:
First Name:HITEKSHA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5999 NEW WILKE RD BLDG 2
Mailing Address - Street 2:
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-4506
Mailing Address - Country:US
Mailing Address - Phone:847-255-7107
Mailing Address - Fax:847-255-7031
Practice Address - Street 1:5999 NEW WILKE RD BLDG 2
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-4506
Practice Address - Country:US
Practice Address - Phone:847-255-7107
Practice Address - Fax:847-255-7031
Is Sole Proprietor?:No
Enumeration Date:2018-08-05
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.017560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209017560OtherSTATE LICENSE