Individual provider Active NPI

Neela Patel, MD

  • Pediatrics Physician
  • Olympia Fields, IL
National Provider Identifier
1114085586
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-112885 Issued in IL
Practice address
3700 W 203Rd St
Suite 201
Olympia Fields, IL 60461-1180
Phone
(708) 679-2880
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-112885 IL Primary

Addresses

Primary practice location

3700 W 203Rd St
Suite 201
Olympia Fields, IL 60461-1180

Mailing address

35318 Eagle Way
Chicago, IL 60678-1353

Other identifiers 2

IdentifierTypeStateIssuer
IL5686047OtherILMEDICARE PTAN
PAYEE 2MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address npatel4719@Direct.FranciscanAlliance.org Direct

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
I20070402000584 IL Practitioner - Pediatric Medicine 7315041266 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-112885ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physicians of Illinois, LLC Pediatrics Current Accepting new patients
Specialty Physicians of Illinois, LLC CurrentSince Jul 1, 2020 Accepting new patients

Locations

35318 Eagle Way
Chicago, IL 60678

333 Dixie Hwy
Chicago Hts, IL 60411
Phone (708) 756-0100

10043 W Lincoln Hwy
Frankfort, IL 60423
Phone (815) 469-0609

18636 Dixie Hwy
Homewood, IL 60430
Phone (708) 647-0571

1938 E Lincoln Hwy
Ste 207
New Lenox, IL 60451
Phone (815) 463-9040

3700 W 203rd St
Ste 201B
Olympia Fields, IL 60461
Phone (708) 679-2880

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

3700 W 203rd St
Ste 103
Olympia Flds, IL 60461
Phone (708) 679-2130

3700 W 203rd St
Ste 201
Olympia Flds, IL 60461
Phone (708) 679-2880

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

Interoperability endpoints

  • Direct secure messaging: npatel4719@direct.franciscanalliance.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1114085586",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W 203RD ST",
            "address_2": "SUITE 201",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611180",
            "telephone_number": "708-679-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NEELA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-112885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL5686047",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PAYEE 2",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npatel4719@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3700 W 203rd St",
            "address_2": "Suite 201",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604611180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

Verify at the official NPI Registry.