Individual provider Active NPI

Nilam M Patel, PA-C

  • Physician Assistant
  • McHenry, IL
National Provider Identifier
1053678557
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085005768 Issued in IL
Practice address
4201 W Medical Center Dr
McHenry, IL 60050
Phone
(815) 344-5000
NPI assigned
Apr 20, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1716 KY
Physician Assistant 363A00000X 085005768 IL Primary

Addresses

Primary practice location

4201 W Medical Center Dr
McHenry, IL 60050

Mailing address

10350 Haligus Rd
Huntley, IL 60142-9545
Phone (815) 338-6600

Other practice location 1

85 N Grand Ave
Fort Thomas, KY 41075-1793
Phone (859) 572-3617

Other practice location 2

360 Station Dr
Crystal Lake, IL 60014-7978
Phone (815) 338-6600

Other practice location 3

1925 Huntley Rd
West Dundee, IL 60118-9301
Phone (815) 338-6600

Other practice location 4

2507 N Richmond Rd
McHenry, IL 60051-5407
Phone (815) 338-6600

Other practice location 5

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 344-5000

Other identifiers 2

IdentifierTypeStateIssuer
085005768OtherILSTATE LICENSE
7100224850MedicaidKY

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
I20161019000878 IL Practitioner - Physician Assistant 0749444982 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10400 Haligus Rd
Huntley, IL 60142-9553

4309 W Medical Ctr Dr
Suite A200
McHenry, IL 60050-8437
Phone (815) 759-8070

515 Valley View Dr
Suite 201
Moline, IL 61265-6175
Phone (312) 695-0870

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085005768ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2019 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053678557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 HALIGUS RD",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601429545",
            "telephone_number": "815-338-6600",
            "fax_number": "847-802-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "60050",
            "telephone_number": "815-344-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 N Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Thomas",
            "state": "KY",
            "postal_code": "410751793",
            "country_code": "US",
            "telephone_number": "859-572-3617",
            "fax_number": "859-572-2366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Station Dr",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147978",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "815-455-8044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1925 Huntley Rd",
            "address_purpose": "LOCATION",
            "city": "West Dundee",
            "state": "IL",
            "postal_code": "601189301",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "847-426-5162",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2507 N Richmond Rd",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600515407",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "815-385-3255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 W Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "60050",
            "country_code": "US",
            "telephone_number": "815-344-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NILAM",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1716",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "085005768",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100224850",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.