Pooja Dave Patel, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209011185 Issued in IL

Practice address

1809 W Chicago Ave # 5
Chicago, IL 60622-5677

Phone

(630) 709-7818

NPI assigned

Jun 6, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Community Medicine Associates

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1245313329

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672012800000",
    "number": "1639430655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 W VAN BUREN ST APT 4D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073535",
            "telephone_number": "630-709-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 W CHICAGO AVE # 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225677",
            "telephone_number": "630-709-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "POOJA",
        "middle_name": "DAVE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209011185",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011185",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "277.001241",
            "identifier": "277.001241",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pinkey Patel
• Pooja Patel
• Pooja Patel, FNP
• Pooja Patel, OD
• Pooja Ashok Patel, DROT, OTR/L
• Pooja M Patel
• Pooja Nikunj Patel, D.O.
• Prabha Patel, OTR/L
• Prachiben Patel, MD
• Pramod M Patel, M.D.

• Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2022; 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.