NPIMap

Individual provider Active NPI

Mukesh V Patel

  • Geriatric Medicine (Internal Medicine) Physician
  • Pontiac, IL
National Provider Identifier
1780602946
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Practice address
2500 W Reynolds St
Pontiac, IL 61764-9774
Phone
(815) 844-5115
Fax
(815) 842-2152
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X IL Primary

Addresses

Primary practice location

2500 W Reynolds St
Pontiac, IL 61764-9774

Mailing address

2500 W Reynolds St
Pontiac, IL 61764-9774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060905000235 IL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 3476557521 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint James HospitalGroup PAC ID 0648187252, 74 clinicians

Practice addresses (Care Compare)

2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
24 On Physicians, PC CurrentSince Jun 1, 2016 Accepting new patients
24 On Physicians, P.C. CurrentSince Jun 1, 2016 Accepting new patients
Saint James Hospital CurrentSince Dec 1, 2022 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Saint James Hospital Past Accepting new patients

Locations

106 S 1st St
Fairbury, IL 61739
Phone (815) 635-3177

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

2500 W Reynolds St
Ste 203
Pontiac, IL 61764
Phone (815) 844-2001

2500 W Reynolds St
Ste 205
Pontiac, IL 61764

2500 W Reynolds St
Ste 207
Pontiac, IL 61764
Phone (815) 579-9002

2500 W Reynolds St
#203
Pontiac, IL 61764
Phone (815) 844-5115

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1780602946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W REYNOLDS ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W REYNOLDS ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617649774",
            "telephone_number": "815-844-5115",
            "fax_number": "815-842-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MUKESH",
        "middle_name": "V",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, IL

Sources for this page

Verify at the official NPI Registry.