NPIMap

Individual provider Active NPI

Niral B Patel, M.D.

  • Family Medicine Physician
  • Crystal Lake, IL
National Provider Identifier
1083845945
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23371 Issued in WI
Practice address
360 Station Dr
Crystal Lake, IL 60014
Phone
(815) 338-6600
Fax
(815) 455-8044
NPI assigned
Jul 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036136344 IL
Family Medicine Physician 207Q00000X 4301095199 MI
Family Medicine Physician 207Q00000X 036136344 IL
Family Medicine Physician 207Q00000X 23371 WI Primary

Addresses

Primary practice location

360 Station Dr
Crystal Lake, IL 60014

Mailing address

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

Other practice location 1

1600 Brady St
Chesaning, MI 48616-1086
Phone (989) 845-1800

Other practice location 2

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

Other practice location 3

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

Other practice location 4

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

Other practice location 5

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 362-2900

Other practice location 6

6345 W 79th St
Burbank, IL 60459-1133
Phone (312) 609-0300

Other identifiers 2

IdentifierTypeStateIssuer
036136344OtherILSTATE LICENSE
100043263MedicaidWI

Electronic endpoints 4

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address npatel250263@direct.myadvocateaurora.org Direct
Direct Messaging Address npatel250263@direct.myadvocateaurora.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, SD, WI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20161025000263 IL Practitioner - Family Practice 4587815329 Reassigns benefits to 3 organizations
I20190226003145 SD Practitioner - Family Practice 4587815329 Reassigns benefits to 1 organization
I20221116001044 WI Practitioner - Family Practice 4587815329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Rapid City Hospital IncGroup PAC ID 6002729506, 560 clinicians

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-1000

Hospital & facility affiliations

  • Monument Health Rapid City Hospital Hospital, Rapid City, SD, CCN 430077
  • Monument Health Spearfish Hospital Hospital, Spearfish, SD, CCN 430048
  • Monument Health Custer Hospital Hospital, Custer, SD, CCN 431323
  • PHS Indian Hospital at Rosebud Hospital, Rosebud, SD, CCN 430084
  • Monument Health Sturgis Hospital Hospital, Sturgis, SD, CCN 431321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036136344ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Feb 13, 2019 Accepting new patients
Aurora Medical Group, Inc. Family Medicine Current Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Nov 1, 2022 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Feb 13, 2019 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2022 Accepting new patients
24 On Physicians, P.C. CurrentSince Aug 1, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2019 Accepting new patients
Lake County Acute Care, LLP Family Medicine Current Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Aurora Advanced Healthcare, Inc. Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2022 Accepting new patients
Lake County Acute Care, LLP Family Medicine CurrentSince Jan 4, 2020 Accepting new patients
Lake County Acute Care, LLP Family Medicine CurrentSince Jan 4, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2019 Accepting new patients
Lakeshore Medical Clinic, LLC Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
24 On Physicians, PC CurrentSince Aug 1, 2023 Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

150 W Half Day Rd
Buffalo Grove, IL 60089
Phone (847) 215-0000

405 W Jackson St
Carbondale, IL 62901

Dept 5777
Carol Stream, IL 60122

360 Station Dr
Ste 150
Crystal Lake, IL 60014

360 Station Dr
Crystal Lake, IL 60014
Phone (815) 477-7350

1445 N Hunt Club Rd
Ste 101
Gurnee, IL 60031
Phone (847) 438-1779

201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171

10350 Haligus Rd
Huntley, IL 60142
Phone (847) 802-7150

11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

6 E Phillip Rd
Ste 1102
Vernon Hills, IL 60061
Phone (847) 680-0500

6 E Phillip Rd
Vernon Hills, IL 60061
Phone (847) 362-5353

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Interoperability endpoints

  • Direct secure messaging: npatel250263@direct.myadvocateaurora.org

Organizations & group practices 16

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

View all 16

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1083845945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 STATION DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147978",
            "telephone_number": "815-338-6600",
            "fax_number": "815-455-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 STATION DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "815-338-6600",
            "fax_number": "815-455-8044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Brady St",
            "address_purpose": "LOCATION",
            "city": "Chesaning",
            "state": "MI",
            "postal_code": "486161086",
            "country_code": "US",
            "telephone_number": "989-845-1800",
            "fax_number": "989-845-1800",
            "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": "10350 Haligus Rd",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429545",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "847-802-7112",
            "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": "801 S Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600483204",
            "country_code": "US",
            "telephone_number": "847-362-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6345 W 79th St",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "IL",
            "postal_code": "604591133",
            "country_code": "US",
            "telephone_number": "312-609-0300",
            "fax_number": "708-684-3070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIRAL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-27",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036136344",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301095199",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036136344",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "23371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036136344",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100043263",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6345 W 79th St",
            "city": "Burbank",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604591133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "801 S Milwaukee Ave",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npatel250263@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "801 S Milwaukee Ave",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npatel250263@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "6345 W 79th St",
            "city": "Burbank",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604591133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.