Patel, Samir A

Patel, Samir A is an sole proprietor health care provider with primary practice located at 1730 E Lake Shore Dr , Decatur IL 62521-3809. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Patel, Samir A can be contacted via phone (217) 329-1000.

Contact Information

Primary practice address
1730 E Lake Shore Dr Decatur IL 62521-3809
Fax: (217) 329-1055
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036096741 Illinois

Profile Details

NPI number 1992704332
LBN Legal business name Patel, Samir A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2005
Last updated Dec 30th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992704332 NPPES
Illinois MEDICAID 036094812

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