Individual provider Active NPI

Jaimini Mayank Patel

  • Physical Therapy Assistant
  • Northbrook, IL
National Provider Identifier
1447950886
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160.005052 Issued in IL
Practice address
1000 Sunset Ridge Rd
Northbrook, IL 60062-4008
Phone
(224) 235-4639
NPI assigned
Mar 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.005052 IL Primary

Addresses

Primary practice location

1000 Sunset Ridge Rd
Northbrook, IL 60062-4008

Mailing address

7937 Lyons St
Morton Grove, IL 60053-1636
Phone (847) 858-6186

Other practice location 1

1815 Norwood Ct
Evanston, IL 60201-1841
Phone (847) 960-5555

Other practice location 2

2200 Golf Rd
Glenview, IL 60025-4903
Phone (847) 416-8912

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
160.005052ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1447950886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7937 LYONS ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600531636",
            "telephone_number": "847-858-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SUNSET RIDGE RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624008",
            "telephone_number": "224-235-4639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1815 Norwood Ct",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011841",
            "country_code": "US",
            "telephone_number": "847-960-5555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 Golf Rd",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600254903",
            "country_code": "US",
            "telephone_number": "847-416-8912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JAIMINI",
        "middle_name": "MAYANK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.005052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.