Palos Medical Care SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036091090 Issued in IL

Legal business name

PALOS MEDICAL CARE SC

Practice address

12800 S Ridgeland Ave
Unit D
Palos Heights, IL 60463

Phone

(708) 389-7663

Fax

(708) 389-7664

NPI assigned

Nov 9, 2006

Last updated

Jan 26, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

PALOS MEDICAL CAREAs reported in NPPES

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

Authorized official

Name

Dr. Pranav Patel, MDNPI 1811067275

Title

President

Phone

(708) 389-7663

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Palos Medical Care SC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pranav S Patel, MD

  • Internal Medicine Physician
  • Palos Heights, IL
  • NPI 1811067275
  Authorized official Same address or phone

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485388800000",
    "number": "1073683439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 762",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "60482",
            "telephone_number": "708-389-7663",
            "fax_number": "708-389-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 S RIDGELAND AVE",
            "address_2": "UNIT D",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "60463",
            "telephone_number": "708-389-7663",
            "fax_number": "708-389-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOS MEDICAL CARE SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALOS MEDICAL CARE",
        "enumeration_date": "2006-11-09",
        "last_updated": "2017-01-26",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PRANAV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-389-7663",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036091090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091090",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palos Heights Fire Protection District
• Palos Heights Medical Center (shakir moiduddin)
• Palos Heights School District 128
• Palos Heights Sleep Center LTD
• Palos Hills Pharmacy, Inc. (Hills Drug Palos)
• Palos Pain Center
• Palos Pediatric Dentistry, PC
• Palos Psychiatric & Recovery Inst LTD
• Palos Psychotherapy Associates, LLC
• Palos Sleep Center LTD

• Family Medicine Physician in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.