Active NPI
Mukesh C Patel, M.D.
- Obstetrics & Gynecology Physician
- Chicago, IL
National Provider Identifier
1396739223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 036 064813
- Practice address
- 6084 S Archer Ave
Chicago, IL 60638-2773 - Phone
- (773) 884-3380
- Fax
- (773) 884-4263
- NPI assigned
- Sep 7, 2005
- Reactivated
- Mar 30, 2006
- Last updated
- Mar 23, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 036 064813 | IL | Primary |
Addresses
Primary practice location
6084 S Archer Ave
Chicago, IL 60638-2773
Mailing address
809 Saint Stephens GRN
Oak Brook, IL 60523-2567
Phone (773) 884-3380
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036064813 | Medicaid | IL |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036 064813 | IL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathology Services Illinois, LTD | Current | Accepting new patients | |
| Saint Anthony Health Affiliates | Obstetrics & Gynecology | Current | Accepting new patients |
Locations
2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300
4177 S Archer Ave
Chicago, IL 60632
Phone (773) 254-2222
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1881086064
-
- Obstetrics & Gynecology Physician
- Chicago, IL
- NPI 1881876209
-
- Anatomic Pathology & Clinical Pathology Physician
- Chicago, IL
- NPI 1013012939
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1295757771
Obstetrics & Gynecology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332460800000",
"number": "1396739223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 SAINT STEPHENS GRN",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605232567",
"telephone_number": "773-884-3380",
"fax_number": "773-884-4263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6084 S ARCHER AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606382773",
"telephone_number": "773-884-3380",
"fax_number": "773-884-4263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "MUKESH",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-07",
"last_updated": "2012-03-23",
"deactivation_date": "2006-03-24",
"reactivation_date": "2006-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "036 064813",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036064813",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.