Active NPI
Vishal K Patel OD PC
- Optometrist
- Northlake, IL
National Provider Identifier
1669938148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- VISHAL K PATEL OD PC
- Practice address
- 137 W North Ave
Northlake, IL 60164-2316 - Phone
- (847) 501-0319
- NPI assigned
- Feb 20, 2019
- Organization subpart
- Yes
- Parent organization
- VISHAL K PATEL OD PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Vishal K Patel, OD
- Title
- Owner
- Phone
- (847) 501-0319
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
137 W North Ave
Northlake, IL 60164-2316
Mailing address
1802 E Basswood LN
Mt Prospect, IL 60056-1810
Phone (847) 501-0319
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046010655 | Medicaid | IL |
Other names 1
- ESSENTIAL EYE CARE
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190415001336 | IL | Part B Supplier - Clinic/Group Practice | 5496096760 |
Receives reassigned benefits from 1 practitioner Practice locations: Northlake, IL |
National Provider Directory
National Provider Directory- Part of
- Vishal K Patel OD PC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550620800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1550620800000",
"number": "1669938148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 E BASSWOOD LN",
"city": "MT PROSPECT",
"state": "IL",
"postal_code": "600561810",
"telephone_number": "847-501-0319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 W NORTH AVE",
"city": "NORTHLAKE",
"state": "IL",
"postal_code": "601642316",
"telephone_number": "847-501-0319"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VISHAL K PATEL OD PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "VISHAL K PATEL OD PC",
"enumeration_date": "2019-02-20",
"last_updated": "2019-02-20",
"status": "A",
"authorized_official_last_name": "PATEL",
"authorized_official_first_name": "VISHAL",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "847-501-0319",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "046010655",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ESSENTIAL EYE CARE",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Northlake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.