Individual provider Active NPI

Dipen Patel

  • Physical Therapist
  • Niles, IL
National Provider Identifier
1154953503
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.022944 Issued in IL
Practice address
8064 W Lyons St
Niles, IL 60714-1332
Phone
(224) 616-7024
NPI assigned
Feb 4, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.022944 IL Primary

Addresses

Primary practice location

8064 W Lyons St
Niles, IL 60714-1332

Mailing address

8064 W Lyons St
Niles, IL 60714-1332
Phone (224) 616-7024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200428002094 IL Practitioner - Physical Therapist in Private Practice 9931539277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
At Still University, Arizona School of Dentistry & Oral HLTH, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8064 W Lyons St
Niles, IL 60714-1332
Phone (224) 616-7024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.022944ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Rehab Services LLC Physical Therapist CurrentSince Nov 1, 2021 Accepting new patients
Healing Joints LLC CurrentSince Oct 28, 2020 Accepting new patients

Locations

1600 W Dempster St
Ste 102
Park Ridge, IL 60068
Phone (847) 296-9040

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1154953503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8064 W LYONS ST",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141332",
            "telephone_number": "224-616-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8064 W LYONS ST",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141332",
            "telephone_number": "224-616-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "DIPEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-04",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.022944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.