Individual provider Active NPI

Meeta Jain Patel, MD

  • Physical Medicine & Rehabilitation Physician
  • Indian Head Park, IL
National Provider Identifier
1194889691
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036112281 Issued in IL
Practice address
6264 Edgebrook LN E
Indian Head Park, IL 60525-6994
Phone
(708) 246-4627
Fax
(708) 246-4627
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 036112281 IL Primary

Addresses

Primary practice location

6264 Edgebrook LN E
Indian Head Park, IL 60525-6994

Mailing address

6264 Edgebrook LN E
Indian Head Park, IL 60525-6994
Phone (708) 246-4627

Other identifiers 1

IdentifierTypeStateIssuer
036112281MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab and Health, LLC Physical Medicine & Rehabilitation Past Accepting new patients
Rehabilitation Specialists of Chicago, LLC Physical Medicine & Rehabilitation PastSince Jan 4, 2010 Accepting new patients

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1194889691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6264 EDGEBROOK LN E",
            "city": "INDIAN HEAD PARK",
            "state": "IL",
            "postal_code": "605256994",
            "telephone_number": "708-246-4627",
            "fax_number": "708-246-4627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6264 EDGEBROOK LN E",
            "city": "INDIAN HEAD PARK",
            "state": "IL",
            "postal_code": "605256994",
            "telephone_number": "708-246-4627",
            "fax_number": "708-246-4627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MEETA",
        "middle_name": "JAIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036112281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112281",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Head Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.