Individual provider Active NPI

Priyanka Patel

  • Family Nurse Practitioner
  • Lisle, IL
National Provider Identifier
1225818404
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.028471 Issued in IL
Practice address
550 Warrenville Rd
Lisle, IL 60532-4308
Phone
(855) 696-0073
NPI assigned
Oct 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.028471 IL Primary

Addresses

Primary practice location

550 Warrenville Rd
Lisle, IL 60532-4308

Mailing address

22 Prairie Pointe LN
Streamwood, IL 60107-2358
Phone (847) 942-5101

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127000722 IL Practitioner - Nurse Practitioner 9638527062 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.028471ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbe Senior Medical Illinois PC CurrentSince Oct 17, 2023 Accepting new patients

Locations

225 W Washington St
Ste 1700
Chicago, IL 60606
Phone (234) 200-4220

225 W Washington St
Ste 1500
Chicago, IL 60606
Phone (312) 776-2422

550 Warrenville Rd
Ste 200
Lisle, IL 60532
Phone (312) 776-2422

Organizations & group practices 1

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": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1225818404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PRAIRIE POINTE LN",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072358",
            "telephone_number": "847-942-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WARRENVILLE RD",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605324308",
            "telephone_number": "855-696-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRIYANKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-04",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.028471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.