Active NPI
Archna Nisarg Patel, OD
- Optometrist
- Berwyn, IL
National Provider Identifier
1346778321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046011109
- Practice address
- 6233 Cermak Rd
Berwyn, IL 60402-2317 - Phone
- (708) 749-2020
- NPI assigned
- Jun 2, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046011109 | IL | Primary |
Addresses
Primary practice location
6233 Cermak Rd
Berwyn, IL 60402-2317
Mailing address
6233 Cermak Rd
Berwyn, IL 60402
Phone (708) 749-2020
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046011109 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1346778321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6233 CERMAK RD",
"city": "BERWYN",
"state": "IL",
"postal_code": "60402",
"telephone_number": "708-749-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6233 CERMAK RD",
"city": "BERWYN",
"state": "IL",
"postal_code": "604022317",
"telephone_number": "708-749-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "ARCHNA",
"middle_name": "NISARG",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-02",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046011109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.