Active NPI
Ravi Dipak Patel
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
- Park Ridge, IL
National Provider Identifier
1174083414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
- License
- 036.180050
- Practice address
- 1875 Dempster St Ste 665
Park Ridge, IL 60068-1168 - Phone
- (847) 825-1590
- NPI assigned
- Mar 22, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician | 207VF0040X | 036.180050 | IL | Primary |
| Obstetrics & Gynecology Physician | 207V00000X | 125074871 | IL |
Addresses
Primary practice location
1875 Dempster St Ste 665
Park Ridge, IL 60068-1168
Mailing address
5045 Carol St
Skokie, IL 60077-2202
Phone (847) 852-9438
Other practice location 1
330 Mount Auburn St
Cambridge, MA 02138-5502
Phone (617) 492-3500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240201001913 | MA | Practitioner - Obstetrics/Gynecology | 5597090159 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1015458 | MA | MD | Female Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loyola University Medical Center | Current | Accepting new patients | |
| Illinois Urogynecology, LTD. | Urogynecology and Reconstructive Pelvic Surgery | Past | Accepting new patients |
Locations
2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400
Interoperability endpoints
- rpatel102043@direct.luhs.org
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.
-
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
- Park Ridge, IL
- NPI 1063421899
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781827200000",
"number": "1174083414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5045 CAROL ST",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600772202",
"telephone_number": "847-852-9438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1875 DEMPSTER ST STE 665",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681168",
"telephone_number": "847-825-1590"
}
],
"practiceLocations": [
{
"address_1": "330 Mount Auburn St",
"address_purpose": "LOCATION",
"city": "Cambridge",
"state": "MA",
"postal_code": "021385502",
"country_code": "US",
"telephone_number": "617-492-3500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATEL",
"first_name": "RAVI",
"middle_name": "DIPAK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-22",
"last_updated": "2026-06-19",
"certification_date": "2026-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "207VF0040X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
"state": "IL",
"license": "036.180050",
"primary": true
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "125074871",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.