Active NPI
Krupa Patel
- Otolaryngology Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 036165440
- Practice address
- 1611 W Harrison St Ste 550
Chicago, IL 60612-4861 - Phone
- (312) 942-6100
- NPI assigned
- May 4, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Otolaryngology Physician | 207Y00000X | 036165440 | IL | Primary |
Addresses
Primary practice location
1611 W Harrison St Ste 550
Chicago, IL 60612-4861
Mailing address
1611 W Harrison St Ste 550
Chicago, IL 60612-4861
Phone (312) 942-6100
Other practice location 1
243 Charles St
Boston, MA 02114-3002
Phone (617) 573-7900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1016 Main Ave
Clifton, NJ 07011-2327
1124 W Adams St
Unit 3W
Chicago, IL 60607-0901
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036165440 | IL | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush University Medical Group | Otolaryngology | Current | Accepting new patients |
| Rush University Medical Center | Current | Accepting new patients | |
| NJ Eye and Ear LLC | Current | Accepting new patients | |
| Clifton Eye Care LLC | Past | Accepting new patients |
Locations
75 Remittance Dr
Dept 1611
Chicago, IL 60675
1611 W Harrison St
Ste 550
Chicago, IL 60612
Phone (312) 563-4431
1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875
1016 Main Ave
Clifton, NJ 07011
Phone (973) 546-5700
23 W Palisade Ave
Englewood, NJ 07631
Phone (201) 408-4441
245 Engle St
Englewood, NJ 07631
Phone (201) 568-0770
Organizations & group practices 4
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.
-
- Ophthalmology Physician
- Englewood, NJ
- NPI 1356860811
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1689165540
-
- Ophthalmology Physician
- Clifton, NJ
- NPI 1699838672
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692921600000",
"number": "1871029272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 W HARRISON ST STE 550",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124861",
"telephone_number": "312-942-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 W HARRISON ST STE 550",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124861",
"telephone_number": "312-942-6100"
}
],
"practiceLocations": [
{
"address_1": "243 Charles St",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021143002",
"country_code": "US",
"telephone_number": "617-573-7900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATEL",
"first_name": "KRUPA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-04",
"last_updated": "2023-08-25",
"certification_date": "2023-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IL",
"license": "036165440",
"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 Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.