Active NPI
Raj Patel, M.D.
- Internal Medicine Physician
- Bartlett, IL
National Provider Identifier
1508930736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036-057526
- Practice address
- 385 Bartlett PLZ
Bartlett, IL 60103-4234 - Phone
- (630) 289-6024
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036-057526 | IL | Primary |
Addresses
Primary practice location
385 Bartlett PLZ
Bartlett, IL 60103-4234
Mailing address
385 Bartlett PLZ
Bartlett, IL 60103-4234
Phone (630) 289-6024
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036057526 | Medicaid | IL | |
| 2160975936 | Other | IL | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-057526 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331683200000",
"number": "1508930736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "385 BARTLETT PLZ",
"city": "BARTLETT",
"state": "IL",
"postal_code": "601034234",
"telephone_number": "630-289-6024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "385 BARTLETT PLZ",
"city": "BARTLETT",
"state": "IL",
"postal_code": "601034234",
"telephone_number": "630-289-6024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "RAJ",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2012-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-057526",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036057526",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "2160975936",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bartlett, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.