Individual provider Active NPI

Amee Patel, PA-C

  • Physician Assistant
  • Waukegan, IL
National Provider Identifier
1023223310
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-001977 Issued in IL
Practice address
1324 N Sheridan Rd
Waukegan, IL 60085-2161
Phone
(847) 360-4090
NPI assigned
May 11, 2007
Last updated
Dec 8, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Emergency Response Attendant 146D00000X ME085001977 IL
Physician Assistant 363A00000X 085-001977 IL Primary

Addresses

Primary practice location

1324 N Sheridan Rd
Waukegan, IL 60085-2161

Mailing address

2100 Powell St
Ste 900
Emeryville, CA 94608-1844
Phone (510) 350-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408000393 IL Practitioner - Physician Assistant 2769475219 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007647NYMDMental Health Counselor
ME085001977ILMDPersonal Emergency Response Attendant
085-001977ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP CurrentSince Jan 1, 2015 Accepting new patients
Cepamerica Illinois LLP CurrentSince Jan 1, 2015 Accepting new patients
Waukegan Clinic Corp Past Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
Midway Emergency Physicians, LLC Past Accepting new patients
Vireo Emergency Physicians LLC Past Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1023223310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081844",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "AMEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "IL",
            "license": "ME085001977",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.