Active NPI
Chandrabala K Patel, RPH
- Pharmacist
- Bolingbrrok, IL
National Provider Identifier
1841573342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051-032985
- Practice address
- 695 W Boughton Rd
Bolingbrrok, IL 60440-1742 - Phone
- (630) 771-1494
- Fax
- (630) 771-1542
- NPI assigned
- Sep 21, 2011
- Last updated
- Sep 21, 2011
- Sex
- Female
- 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 | 051-032985 | IL | Primary |
Addresses
Primary practice location
695 W Boughton Rd
Bolingbrrok, IL 60440-1742
Mailing address
695 W Boughton Rd
Bolingbrook, IL 60440-1752
Phone (630) 771-1494
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051-032985 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co. | 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": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1841573342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "695 W BOUGHTON RD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604401752",
"telephone_number": "630-771-1494",
"fax_number": "630-771-1542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "695 W BOUGHTON RD",
"city": "BOLINGBRROK",
"state": "IL",
"postal_code": "604401742",
"telephone_number": "630-771-1494",
"fax_number": "630-771-1542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "CHANDRABALA",
"middle_name": "K",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-21",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-032985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.