Individual provider Active NPI

Jill R. Patel

  • Family Nurse Practitioner
  • Bartlett, IL
National Provider Identifier
1336916477
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209028928 Issued in IL
Practice address
142-E S Randall Rd.
Bartlett, IL 60134
Phone
(331) 248-1321
NPI assigned
Dec 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209028928 IL Primary
Registered Nurse 163W00000X 041495188 IL

Addresses

Primary practice location

142-E S Randall Rd.
Bartlett, IL 60134

Mailing address

1020 Longford Rd
Bartlett, IL 60103-1912
Phone (630) 864-0338

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041495188ILMDRegistered Nurse
209028928ILMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1336916477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 LONGFORD RD",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031912",
            "telephone_number": "630-864-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142-E S RANDALL RD.",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "60134",
            "telephone_number": "331-248-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JILL",
        "middle_name": "R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209028928",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041495188",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Dec 8, 2023; 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.