NPIMap

Individual provider Active NPI

Ketki Modi, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
National Provider Identifier
1477502326
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036-096575 Issued in IL
Practice address
5145 N California Ave
SCH Dept of Rehab Services
Chicago, IL 60625-3661
Phone
(773) 878-8200
Fax
(773) 907-3032
NPI assigned
May 9, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 036-096575 IL Primary

Addresses

Primary practice location

5145 N California Ave
SCH Dept of Rehab Services
Chicago, IL 60625-3661

Mailing address

5145 N California Ave
SCH Dept of Rehab Services
Chicago, IL 60625-3661
Phone (773) 878-8200

Other names 1

  • Dr. Ketki Patel Former name

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
I20040603000387 IL Practitioner - Physical Medicine and Rehabilitation 6204818263 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Michigan State University College of Human Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Rehabilitation Care, LLCGroup PAC ID 8628253259, 21 clinicians

Practice addresses (Care Compare)

9700 Gross Point Rd
Skokie, IL 60076-1175
Phone (847) 674-7210

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-096575ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Rehabilitation Care, LLC Physical Medicine & Rehabilitation CurrentSince Feb 15, 2021 Accepting new patients
Tullia LLC CurrentSince May 1, 2024 Accepting new patients
Swedish Covenant Management Services, Inc. CurrentSince Mar 1, 2004 Accepting new patients
Swedish Covenant Management Services, Inc. Physical Medicine & Rehabilitation Current Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Mar 1, 2004 Accepting new patients
Clear Cognition PLLC PastSince Jun 15, 2021 Accepting new patients
Schwab Rehabilitation Hospital and Care Network Past Accepting new patients

Locations

1401 S California Ave
Chicago, IL 60608
Phone (773) 522-5853

2740 W Foster Ave
Ste 310
Chicago, IL 60625

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

5145 N California Ave
Chicago, IL 60625
Phone (773) 989-3800

60 Revere Dr
Ste 770
Northbrook, IL 60062
Phone (312) 731-1999

9700 Gross Point Rd
Skokie, IL 60076
Phone (847) 674-7210

200 N Bryant Ave
Ste 10
Edmond, OK 73034

Organizations & group practices 7

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 4

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477502326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5145 N CALIFORNIA AVE",
            "address_2": "SCH DEPT OF REHAB SERVICES",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253661",
            "telephone_number": "773-878-8200",
            "fax_number": "773-907-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 N CALIFORNIA AVE",
            "address_2": "SCH DEPT OF REHAB SERVICES",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253661",
            "telephone_number": "773-878-8200",
            "fax_number": "773-907-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODI",
        "first_name": "KETKI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2022-07-21",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-096575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KETKI",
            "last_name": "PATEL",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.