Active NPI
Dhairya Patel
- Pharmacist
- Rockford, IL
National Provider Identifier
1730957358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051306041
- Practice address
- 110 S Alpine Rd
Rockford, IL 61108-2122 - Phone
- (815) 399-1015
- Fax
- (815) 399-9540
- NPI assigned
- Dec 13, 2023
- Last updated
- Dec 13, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051306041 | IL | Primary |
Addresses
Primary practice location
110 S Alpine Rd
Rockford, IL 61108-2122
Mailing address
110 S Alpine Rd
Rockford, IL 61108-2122
Phone (815) 399-1015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051306041 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highland Park CVS LLC | 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": "1702425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702425600000",
"number": "1730957358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 S ALPINE RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082122",
"telephone_number": "815-399-1015",
"fax_number": "815-399-9540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 S ALPINE RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082122",
"telephone_number": "815-399-1015",
"fax_number": "815-399-9540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "DHAIRYA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-12-13",
"last_updated": "2023-12-13",
"certification_date": "2023-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051306041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.