Basic Information
Provider Information
NPI: 1598144321
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: AMEE
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8558 BROADWAY
Address2:  
City: MERRILLVILLE
State: IN
PostalCode: 464107032
CountryCode: US
TelephoneNumber: 2193927084
FaxNumber: 2197036854
Practice Location
Address1: 1740 W TAYLOR ST
Address2:  
City: CHICAGO
State: IL
PostalCode: 606127232
CountryCode: US
TelephoneNumber: 8666002273
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/26/2015
LastUpdateDate: 10/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207K00000X01086751AINY Allopathic & Osteopathic PhysiciansAllergy & Immunology 
207R00000X036149226ILN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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