Basic Information
Provider Information
NPI: 1588821649
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: SOHAL
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: MD.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 22285 N. PEPPER ROAD
Address2: SUITE 401
City: LAKE BARRINGTON
State: IL
PostalCode: 600102538
CountryCode: US
TelephoneNumber: 8478826604
FaxNumber: 8478394316
Practice Location
Address1: 22285 N. PEPPER ROAD
Address2: SUITE 401
City: LAKE BARRINGTON
State: IL
PostalCode: 600102538
CountryCode: US
TelephoneNumber: 8478826604
FaxNumber: 8478394316
Other Information
ProviderEnumerationDate: 05/16/2008
LastUpdateDate: 12/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X036123056ILY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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