Individual provider Active NPI

Kirit K Patari, MD

  • Family Medicine Physician
  • Streamwood, IL
National Provider Identifier
1740376763
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-046499 Issued in IL
Practice address
77 E Irving Park Rd
Streamwood, IL 60107-2930
Phone
(630) 837-0310
Fax
(630) 806-8172
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-046499 IL Primary

Addresses

Primary practice location

77 E Irving Park Rd
Streamwood, IL 60107-2930

Mailing address

77 E Irving Park Rd
Streamwood, IL 60107-2930
Phone (630) 837-0310

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
I20120214000723 IL Practitioner - Family Practice 8527246578

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-046499ILMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1740376763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 E IRVING PARK RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072930",
            "telephone_number": "630-837-0310",
            "fax_number": "630-806-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 E IRVING PARK RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072930",
            "telephone_number": "630-837-0310",
            "fax_number": "630-806-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATARI",
        "first_name": "KIRIT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-046499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streamwood, IL

Sources for this page

Verify at the official NPI Registry.