Individual provider Active NPI

Pratik Bharat Patel, MD

  • Otolaryngology Physician
  • Chicago, IL
National Provider Identifier
1902224942
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036162746 Issued in IL
Practice address
111 W Jackson Blvd Lbby 106
Chicago, IL 60604-4142
Phone
(888) 938-3838
Fax
(888) 919-1083
NPI assigned
Apr 5, 2014
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 01089706A IN
Otolaryngology Physician 207Y00000X 036162746 IL Primary

Addresses

Primary practice location

111 W Jackson Blvd Lbby 106
Chicago, IL 60604-4142

Mailing address

10001 W Innovation Dr Ste 200
Milwaukee, WI 53226-4851
Phone (888) 938-3838

Other practice location 1

1125 South Blvd
Oak Park, IL 60302-2812
Phone (888) 938-3838

Other practice location 2

17859 80th Ave
Tinley Park, IL 60477-5023
Phone (888) 938-3838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230120000207 IL Practitioner - Otolaryngology 0648523373 Reassigns benefits to 1 organization
I20230719002668 IN Practitioner - Otolaryngology 0648523373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Harvard Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Ear Nose and Throat Specialists PLLCGroup PAC ID 0143657197, 19 clinicians

Practice addresses (Care Compare)

111 W Jackson Blvd
Lbby 106
Chicago, IL 60604-4142
Phone (888) 938-3838

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Ear Nose & Throat Specialists, PLLC Otolaryngology CurrentSince Feb 1, 2023 Accepting new patients
Center for Sleep and Nasal Sinus Disorders, LLC CurrentSince Jun 19, 2023 Accepting new patients
Center for Sleep and Nasal Sinus Disorders, LLC Otolaryngology Past Accepting new patients

Locations

111 W Jackson Blvd
Lbby 106
Chicago, IL 60604

1150 Essington Rd
Ste 101
Joliet, IL 60435
Phone (815) 823-8460

1739 Freedom Dr
Ste 101
Naperville, IL 60563
Phone (630) 799-0122

984 Willow Rd
Ste H
Northbrook, IL 60062

1125 South Blvd
Oak Park, IL 60302

2060 E Algonquin Rd
Ste 720
Schaumburg, IL 60173
Phone (847) 496-4693

17859 80th Ave
Tinley Park, IL 60477
Phone (708) 709-9600

925 N Milwaukee Ave
Unit 200
Vernon Hills, IL 60061

7388 Business Center Dr
Avon, IN 46123
Phone (317) 272-0480

6920 S East St
Ste B
Indianapolis, IN 46227
Phone (317) 497-6880

9500 Priority Way West Dr
#100
Indianapolis, IN 46240

53760 Generations Dr
South Bend, IN 46635
Phone (219) 247-4444

10001 W Innovation Dr
Ste 200
Wauwatosa, WI 53226

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19820/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ppatel@coastal.emadirect.md

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1396656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1902224942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 W INNOVATION DR STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264851",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W JACKSON BLVD LBBY 106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606044142",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 South Blvd",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603022812",
            "country_code": "US",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17859 80th Ave",
            "address_purpose": "LOCATION",
            "city": "Tinley Park",
            "state": "IL",
            "postal_code": "604775023",
            "country_code": "US",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRATIK",
        "middle_name": "BHARAT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01089706A",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036162746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.