Active NPI
Bhavesh K Patel, MD
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1063525202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036-107252
- Practice address
- 4211 N Cicero Ave Ste 100
Chicago, IL 60641-1652 - Phone
- (815) 713-2742
- Fax
- (815) 282-8597
- NPI assigned
- Aug 15, 2006
- Last updated
- Jul 1, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-107252 | IL | Primary |
Addresses
Primary practice location
4211 N Cicero Ave Ste 100
Chicago, IL 60641-1652
Mailing address
10100 Forest Hills Rd
Machesney Park, IL 61115-8234
Phone (815) 713-2742
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036107252 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-107252 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Health Partners,Inc | Family Medicine | Past | Accepting new patients |
| Physicians Immediate Care North Chicago LLC | Past | Accepting new patients | |
| Physicians Immediate Care LTD | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/6217/brand/1/csg/61/fhir/r4
Organizations & group practices 3
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.
-
dba Glendale Family Practice
- Family Medicine Physician
- Bloomingdale, IL
- NPI 1043255888
-
- Urgent Care Clinic/Center
- Rockford, IL
- NPI 1528046323
-
- Urgent Care Clinic/Center
- Chicago, IL
- NPI 1205814118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1063525202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10100 FOREST HILLS RD",
"city": "MACHESNEY PARK",
"state": "IL",
"postal_code": "611158234",
"telephone_number": "815-713-2742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4211 N CICERO AVE STE 100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606411652",
"telephone_number": "815-713-2742",
"fax_number": "815-282-8597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "BHAVESH",
"middle_name": "K",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-107252",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036107252",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.