Active NPI
Jitesh A Patel, PHARM. D
- Pharmacist
- Maywood, IL
National Provider Identifier
1417976952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- Practice address
- 1516 Madison St
Maywood, IL 60153-1824 - Phone
- (708) 345-4658
- Fax
- (708) 345-1011
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | IL | Primary |
Addresses
Primary practice location
1516 Madison St
Maywood, IL 60153-1824
Mailing address
1412 Pine Cove CT
Darien, IL 60561-4999
Phone (630) 427-1768
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 364148087001 | Medicaid | IL |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051-038116 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417976952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1412 PINE COVE CT",
"city": "DARIEN",
"state": "IL",
"postal_code": "605614999",
"telephone_number": "630-427-1768",
"fax_number": "708-345-1011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 MADISON ST",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601531824",
"telephone_number": "708-345-4658",
"fax_number": "708-345-1011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "JITESH",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "PHARM. D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "364148087001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.