Individual provider Active NPI

Alpesh M. Patel, MD

  • Family Medicine Physician
  • Waukegan, IL
National Provider Identifier
1720287378
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036126334 Issued in IL
Practice address
1075N Green Bay Rd
Waukegan, IL 60085-2244
Phone
(847) 782-7120
Fax
(847) 782-7140
NPI assigned
Jul 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036126334 IL Primary
Adult Medicine Physician 207QA0505X 4301089614 MI

Addresses

Primary practice location

1075N Green Bay Rd
Waukegan, IL 60085-2244

Mailing address

1075N Green Bay Rd
Waukegan, IL 60085-2244
Phone (941) 315-6194

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100903000870 IL Practitioner - Family Practice 6901920446 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1075 N Green Bay Rd
Waukegan, IL 60085-2244
Phone (941) 315-6194

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036126334ILMDFamily Medicine Physician
4301089614MIMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpesh Corporation Family Medicine CurrentSince Aug 3, 2013 Accepting new patients
Waukegan Clinic Corp Family Medicine Current Accepting new patients
Oncology Hematology Associates of Northern Illinois, LTD CurrentSince Sep 6, 2011 Accepting new patients

Locations

15 Tower Ct
Ste 210
Gurnee, IL 60031
Phone (847) 599-1444

200 S Greenleaf St
Ste L
Gurnee, IL 60031
Phone (847) 360-7888

1075 N Green Bay Rd
Waukegan, IL 60085
Phone (941) 312-2831

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

Organizations & group practices 3

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1720287378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075N GREEN BAY RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852244",
            "telephone_number": "941-315-6194",
            "fax_number": "941-209-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075N GREEN BAY RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852244",
            "telephone_number": "847-782-7120",
            "fax_number": "847-782-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ALPESH",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036126334",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MI",
            "license": "4301089614",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.