Individual provider Active NPI

Krushan Patel, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Schaumburg, IL
National Provider Identifier
1508218751
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
019.032209 Issued in IL
Practice address
2050 E Algonquin Rd Ste 610
Schaumburg, IL 60173-4166
Phone
(847) 701-0028
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.032209 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 019.032209 IL Primary

Addresses

Primary practice location

2050 E Algonquin Rd Ste 610
Schaumburg, IL 60173-4166

Mailing address

343 W Wolf Point PLZ Unit 209
Chicago, IL 60654-8898
Phone (334) 703-1322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170828002154 KY Order and Referring Only - DentistPractitioner - Dentist 7416229372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.032209ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1508218751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 W WOLF POINT PLZ UNIT 209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606548898",
            "telephone_number": "334-703-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD STE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734166",
            "telephone_number": "847-701-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KRUSHAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032209",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019.032209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.