Individual provider Active NPI

Evita Patel

  • Family Nurse Practitioner
  • Elgin, IL
National Provider Identifier
1649004599
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209029561 Issued in IL
Practice address
801 Villa St
Elgin, IL 60120-8001
Phone
(630) 978-2532
NPI assigned
Aug 30, 2024
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209029561 IL
Family Nurse Practitioner 363LF0000X 209029561 IL Primary

Addresses

Primary practice location

801 Villa St
Elgin, IL 60120-8001

Mailing address

223 Dallas Dr
Bartlett, IL 60103-1305
Phone (630) 965-3729

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241011002662 IL Order and Referring Only - Nurse Practitioner 2062944325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209029561ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vna Health Care Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1649004599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 DALLAS DR",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031305",
            "telephone_number": "630-965-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 VILLA ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601208001",
            "telephone_number": "630-978-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "EVITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209029561",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209029561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.