Organization Active NPI

Advanced Integrative Medicine

  • Internal Medicine Physician
  • Plainfield, IL
National Provider Identifier
1497937536
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036108691 Issued in IL
Legal business name
ADVANCED INTEGRATIVE MEDICINE
Practice address
12624 S Route 59
Plainfield, IL 60585-5448
Phone
(815) 577-6446
Fax
(815) 577-6331
NPI assigned
Nov 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Authorized official

Name
Dr. Kalpesh Patel, M.D.NPI 1154386506
Title
Physician
Phone
(815) 577-6446

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036108691 IL Primary

Addresses

Primary practice location

12624 S Route 59
Plainfield, IL 60585-5448

Mailing address

12624 S Route 59
Plainfield, IL 60585-5448
Phone (815) 577-6446

Other identifiers 2

IdentifierTypeStateIssuer
036108691MedicaidIL
DD8953OtherILRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050712001134 IL Part B Supplier - Clinic/Group Practice 4789610619 Receives reassigned benefits from 8 practitioners
Practice locations: Plainfield, IL; Romeoville, IL; Oswego, IL; Naperville, IL; Bolingbrook, IL; Aurora, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1045386Advanced Integrative Medicine12624 S Route 59, Plainfield, IL 60585Certificate of waiverSep 13, 2027

National Provider Directory

National Provider Directory

Locations

12820 S Route 59
Unit C
Plainfield, IL 60585
Phone (773) 202-8700

12624 S Route 59
Plainfield, IL 60585
Phone (815) 577-0900

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389830400000",
    "number": "1497937536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12624 S ROUTE 59",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605855448",
            "telephone_number": "815-577-6446",
            "fax_number": "815-577-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12624 S ROUTE 59",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605855448",
            "telephone_number": "815-577-6446",
            "fax_number": "815-577-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2014-01-16",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KALPESH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "815-577-6446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036108691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108691",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DD8953",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.