NPIMap

Individual provider Active NPI

Niketa A Patel, D.O.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1427498732
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036139912 Issued in IL
Practice address
3600 W. Fullerton Avenue
Chicago, IL 60647
Phone
(773) 782-2800
Fax
(773) 782-5042
NPI assigned
Jul 1, 2013
Last updated
Aug 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125062694 IL
Family Medicine Physician 207Q00000X 036139912 IL Primary

Addresses

Primary practice location

3600 W. Fullerton Avenue
Chicago, IL 60647

Mailing address

3600 W Fullerton Avenue
Chicago, IL 60647
Phone (773) 782-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180809004604 IL Practitioner - Family Practice 2860740677 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1625 N Harlem Ave
Chicago, IL 60707-4303

1653 W Congress Pkwy
Chicago, IL 60612-3833

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036139912ILMDFamily Medicine Physician
125062694ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Rush University Medical Center CurrentSince Jan 1, 2025 Accepting new patients
Rush Oak Park Physicians Group Anchor Family Medicine CurrentSince Nov 16, 2020 Accepting new patients
Rush Oak Park ER Physicians Group CurrentSince Mar 23, 2020 Accepting new patients
DRS Beamer Carlon Craigen SC Family Medicine Current Accepting new patients
Rush Oak Park Physicians Group Lake Street Family Medicine CurrentSince Aug 1, 2018 Accepting new patients

Locations

1625 N Harlem Ave
Chicago, IL 60707
Phone (708) 312-0360

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Dept 1611
Chicago, IL 60675

75 Remittance Dr
Dept 1620
Chicago, IL 60675

1011 Lake St
Ste 300
Oak Park, IL 60301
Phone (708) 366-7896

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

610 S Maple Ave
Ste 3900
Oak Park, IL 60304
Phone (708) 524-1674

Interoperability endpoints

  • Direct secure messaging: npatel144312@direct.rush.rush-health.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1427498732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W FULLERTON AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60647",
            "telephone_number": "773-782-2800",
            "fax_number": "773-782-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W. FULLERTON AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60647",
            "telephone_number": "773-782-2800",
            "fax_number": "773-782-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIKETA",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125062694",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036139912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.