NPIMap

Individual provider Active NPI

Payal Shah Patel, D.O.

  • Pediatrics Physician
  • Lemont, IL
National Provider Identifier
1497918361
Registry record updated Apr 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.120449 Issued in IL
Practice address
15884 W 127TH St Ste H
Lemont, IL 60439-7425
Phone
(630) 243-7683
Fax
(630) 243-8184
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036.120449 IL Primary

Addresses

Primary practice location

15884 W 127TH St Ste H
Lemont, IL 60439-7425

Mailing address

15884 W 127TH St Ste H
Lemont, IL 60439-7425
Phone (630) 243-7683

Other identifiers 2

IdentifierTypeStateIssuer
036120449 1MedicaidIL
2220936OtherILBCBS

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
036.120449ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Health Ventures Past Accepting new patients
Edward Health Ventures Past Accepting new patients
Edward Health Ventures Past Accepting new patients
Edward Health Ventures Pediatrics Past Accepting new patients
Edward Health Ventures Hospitalist Past Accepting new patients
Edward Health Ventures Past Accepting new patients
Pediatric Wellness Center Pediatrics Past Accepting new patients
Edward Health Ventures Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ppatel251583@direct.myadvocateaurora.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714176000000",
    "number": "1497918361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15884 W 127TH ST STE H",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604397425",
            "telephone_number": "630-243-7683",
            "fax_number": "630-243-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15884 W 127TH ST STE H",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604397425",
            "telephone_number": "630-243-7683",
            "fax_number": "630-243-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PAYAL",
        "middle_name": "SHAH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2024-04-27",
        "certification_date": "2024-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.120449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036120449 1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2220936",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2024; 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.