| Ketan R Patel | |
|
530 Park Ave E Suite 101 Princeton IL 61356-3901 | |
| (815) 872-1221 | |
| (815) 872-2304 |
| Full Name | Ketan R Patel |
|---|---|
| Speciality | Internal Medicine |
| Location | 530 Park Ave E, Princeton, Illinois |
| Authorized Official Name and Position | Ketan R Patel (SELF EMPLOYED) |
| Authorized Official Contact | 8158721221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ketan R Patel 530 Park Ave E Suite 101 Princeton IL 61356-3901 Ph: (815) 872-1221 | Ketan R Patel 530 Park Ave E Suite 101 Princeton IL 61356-3901 Ph: (815) 872-1221 |
| NPI Number | 1114326956 |
|---|---|
| Provider Enumeration Date | 08/18/2014 |
| Last Update Date | 08/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114326956 | NPI | - | NPPES |
| 036083069 | Medicaid | IL | |
| 1114910528 | Other | IL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036083069 (Illinois) | Primary |
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