NPIMap

Organization Active NPI

Raj Patel MD SC

  • Internal Medicine Physician
  • Bartlett, IL
National Provider Identifier
1255512026
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036057526 Issued in IL
Legal business name
RAJ PATEL MD SC
Practice address
385 Bartlett PLZ
Bartlett, IL 60103-4234
Phone
(630) 289-6024
Fax
(630) 289-8400
NPI assigned
Nov 20, 2007
Last updated
Mar 14, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Authorized official

Name
Dr. Raj Patel, M.D.NPI 1508930736
Title
Owner
Phone
(630) 289-6024

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036057526 IL Primary

Addresses

Primary practice location

385 Bartlett PLZ
Bartlett, IL 60103-4234

Mailing address

385 Bartlett PLZ
Bartlett, IL 60103-4234
Phone (630) 289-6024

Other identifiers 2

IdentifierTypeStateIssuer
036057526MedicaidIL
2160975936OtherILBCBS

National Provider Directory

National Provider Directory

Locations

28112 Network Pl
Chicago, IL 60673

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1255512026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 BARTLETT PLZ",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034234",
            "telephone_number": "630-289-6024",
            "fax_number": "630-289-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 BARTLETT PLZ",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601034234",
            "telephone_number": "630-289-6024",
            "fax_number": "630-289-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJ PATEL MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RAJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-289-6024",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036057526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036057526",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2160975936",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.