Chimanbhai Kalidas Patel, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036052687 Issued in IL

Practice address

6555 Willow Springs Rd
Ste 6
La Grange Highlands, IL 60525-4591

Phone

(708) 579-4900

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Jasam Medical SC

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1952479222
  NPD (past) Authorized official

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1710919394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6611 WEDGEWOOD LN",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275440",
            "telephone_number": "630-850-9505",
            "fax_number": "773-292-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 WILLOW SPRINGS RD",
            "address_2": "STE 6",
            "city": "LA GRANGE HIGHLANDS",
            "state": "IL",
            "postal_code": "605254591",
            "telephone_number": "708-579-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "CHIMANBHAI",
        "middle_name": "KALIDAS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036052687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036052687",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sohail Qamar, CSA

• Family Medicine Physician in La Grange Highlands, IL
• Providers in La Grange Highlands, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.