Individual provider Active NPI

Tejalkumari Atit Patel, APN

  • Family Nurse Practitioner
  • Lombard, IL
National Provider Identifier
1306479449
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.020457 Issued in IL
Practice address
2500 S Highland Ave Ste 230
Lombard, IL 60148-7103
Phone
(630) 429-9000
NPI assigned
Feb 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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 209.020457 IL Primary

Addresses

Primary practice location

2500 S Highland Ave Ste 230
Lombard, IL 60148-7103

Mailing address

1580 Spinnaker LN
Hanover Park, IL 60133-6237
Phone (630) 677-5802

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
I20201013002866 IL Practitioner - Nurse Practitioner 0749600773 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.020457ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Services CurrentSince Oct 5, 2020 Accepting new patients

Locations

2500 S Highland Ave
Ste 230
Lombard, IL 60148
Phone (630) 429-9000

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": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1306479449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SPINNAKER LN",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601336237",
            "telephone_number": "630-677-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S HIGHLAND AVE STE 230",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601487103",
            "telephone_number": "630-429-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "TEJALKUMARI",
        "middle_name": "ATIT",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.020457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.