Organization Active NPI

Plastic Surgery Clinic of Chicago LLC

  • Plastic Surgery Physician
  • Chicago, IL
National Provider Identifier
1821501586
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGERY CLINIC OF CHICAGO LLC
Practice address
850 S Wabash Ave Ste 310
Chicago, IL 60605-3642
Phone
(419) 656-6863
NPI assigned
Nov 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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

Authorized official

Name
Parit Patel, MDNPI 1013118140
Title
MD
Phone
(419) 656-6863

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

850 S Wabash Ave Ste 310
Chicago, IL 60605-3642

Mailing address

850 S Wabash Ave Ste 310
Chicago, IL 60605-3642
Phone (419) 656-6863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171226001397 IL Part B Supplier - Clinic/Group Practice 4880952787 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

737 N Michigan Ave
Ste 1820
Chicago, IL 60611
Phone (312) 819-5338

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510704000000",
    "number": "1821501586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S WABASH AVE STE 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053642",
            "telephone_number": "419-656-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S WABASH AVE STE 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053642",
            "telephone_number": "419-656-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY CLINIC OF CHICAGO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-15",
        "last_updated": "2017-11-15",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PARIT",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "419-656-6863",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.