Active NPI
Jashbhai M Patel, M.D.
- Family Medicine Physician
- Chicago Heights, IL
National Provider Identifier
1629141601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036050323
- Practice address
- 30 E 15TH St
Suite 202
Chicago Heights, IL 60411-3459 - Phone
- (708) 754-7777
- Fax
- (708) 754-7701
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | 036-050323 | IL | |
| Family Medicine Physician | 207Q00000X | 036050323 | IL | Primary |
Addresses
Primary practice location
30 E 15TH St
Suite 202
Chicago Heights, IL 60411-3459
Mailing address
30 E 15TH St
Suite 202
Chicago Heights, IL 60411-3459
Phone (708) 754-7777
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01623866 | Other | IL | BLUECROSS BLUESHIELD |
| 036-050323 | Medicaid | IL | |
| 080165392 | Other | IL | MEDICARE RAILROAD |
| F400196012 | Other | IL | MEDICARE PTAN |
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 |
|---|---|---|---|
| 036-050323 | IL | MD | Legal Medicine |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443484800000",
"number": "1629141601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 E 15TH ST",
"address_2": "SUITE 202",
"city": "CHICAGO HEIGHTS",
"state": "IL",
"postal_code": "604113459",
"telephone_number": "708-754-7777",
"fax_number": "708-754-7701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E 15TH ST",
"address_2": "SUITE 202",
"city": "CHICAGO HEIGHTS",
"state": "IL",
"postal_code": "604113459",
"telephone_number": "708-754-7777",
"fax_number": "708-754-7701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "JASHBHAI",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2015-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "IL",
"license": "036-050323",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036050323",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "01623866",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036-050323",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "080165392",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "F400196012",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.