Individual provider Active NPI

Shivani Patel

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1669356721
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
507 N 17TH St
Milwaukee, WI 53233-2104
Phone
(414) 288-5688
NPI assigned
Aug 2, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

507 N 17TH St
Milwaukee, WI 53233-2104

Mailing address

507 N 17TH St
Milwaukee, WI 53233-2104

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
I20251111003004 IL Practitioner - Physician Assistant 7416448097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1645 W School St
Suite a
Chicago, IL 60657-2171

3845 McCoy Dr
Suite 101
Aurora, IL 60504-4429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Immediate Care LLC CurrentSince Sep 16, 2025 Accepting new patients

Locations

7262 Solutions Ctr
Chicago, IL 60677

1645 W School St
Ste A
Chicago, IL 60657
Phone (773) 227-3669

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1754092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1669356721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 N 17TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N 17TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332104",
            "telephone_number": "414-288-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIVANI",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-08-02",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.