Individual provider Active NPI

Komal Mahendrakumar Patel, DO, MPH

  • Family Medicine Physician
  • Homewood, IL
National Provider Identifier
1093459471
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036172403 Issued in IL
Practice address
18408 Governors Hwy
Homewood, IL 60430-2911
Phone
(708) 647-0571
Fax
(708) 647-0676
NPI assigned
Apr 22, 2022
Last updated
Sep 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036172403 IL Primary

Addresses

Primary practice location

18408 Governors Hwy
Homewood, IL 60430-2911

Mailing address

35318 Eagle Way
Chicago, IL 60678-1353
Phone (317) 528-4800

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250710001990 IL Practitioner - Family Practice 8022496900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18408 Governors Hwy
Homewood, IL 60430-2911
Phone (708) 647-0571

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036172403ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physicians of Illinois, LLC Family Medicine CurrentSince Aug 7, 2025 Accepting new patients
Specialty Physicians of Illinois, LLC CurrentSince Aug 7, 2025 Accepting new patients

Locations

35318 Eagle Way
Chicago, IL 60678

18408 Governors Hwy
Homewood, IL 60430
Phone (708) 647-0571

3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850

Interoperability endpoints

  • Direct secure messaging: kpatel1888529@adventhealth.direct-ci.com

Organizations & group practices 2

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 1

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": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1093459471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35318 EAGLE WAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606781353",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18408 GOVERNORS HWY",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302911",
            "telephone_number": "708-647-0571",
            "fax_number": "708-647-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KOMAL",
        "middle_name": "MAHENDRAKUMAR",
        "credential": "DO, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036172403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.