Individual provider Active NPI

Roshan Patel

  • Family Medicine Physician
  • Bloomingdale, IL
National Provider Identifier
1801392717
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-157111 Issued in IL
Practice address
220 Springfield Dr Ste 210
Bloomingdale, IL 60108-2215
Phone
(630) 213-7788
Fax
(630) 289-8450
NPI assigned
Apr 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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 036-157111 IL Primary

Addresses

Primary practice location

220 Springfield Dr Ste 210
Bloomingdale, IL 60108-2215

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-0018
Phone (630) 469-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rpatel232500@direct.edward.org

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
I20210813001975 IL Practitioner - Family Practice 9830449412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

1325 N Meacham Rd
Schaumburg, IL 60173-4824
Phone (630) 469-9200

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone (708) 226-7000

2100 Glenwood Ave
Joliet, IL 60435-5487
Phone (815) 725-2121

30 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-2210

40 S Clay St
Hinsdale, IL 60521-3257

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-157111ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Sep 7, 2021 Accepting new patients
Dupage Medical Group LTD CurrentSince Sep 7, 2021 Accepting new patients

Locations

220 Springfield Dr
Ste 210
Bloomingdale, IL 60108
Phone (630) 213-7788

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

220 Springfield Dr
#210
Bloomingdale, IL 60108
Phone (630) 893-2213

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

Organizations & group practices 2

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": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1801392717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SPRINGFIELD DR STE 210",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082215",
            "telephone_number": "630-213-7788",
            "fax_number": "630-289-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ROSHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-01",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-157111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpatel232500@direct.edward.org",
            "affiliation": "N",
            "address_1": "220 Springfield Dr Ste 210",
            "city": "Bloomingdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601082215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

Verify at the official NPI Registry.