Individual provider Active NPI

Jyothi Deepak Patil, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Aurora, IL
National Provider Identifier
1972537595
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
036108435 Issued in IL
Practice address
2000 Ogden Ave
Aurora, IL 60504-7222
Phone
(314) 849-3535
Fax
(314) 849-6395
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 036108435 IL Primary

Addresses

Primary practice location

2000 Ogden Ave
Aurora, IL 60504-7222

Mailing address

1050 W Kinzie
Chicago, IL 60642-6537
Phone (314) 849-3535

Other identifiers 2

IdentifierTypeStateIssuer
036108435MedicaidIL
P00305120OtherILRAILROAD MEDICARE

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
I20060407000533 IL Practitioner - Pathology 2860401510 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Associates of Aurora LLCGroup PAC ID 9638364011, 3 clinicians

Practice addresses (Care Compare)

2000 Ogden Ave
Aurora, IL 60504-7222
Phone (630) 978-6700

Hospital & facility affiliations

  • Copley Memorial Hospital Hospital, Aurora, IL, CCN 140029
  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036108435ILMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of Aurora LLC CurrentSince Jul 1, 2010 Accepting new patients
Digestive Diseases Consultants of Kankakee, SC CurrentSince Feb 13, 2023 Accepting new patients

Locations

2000 Ogden Ave
Aurora, IL 60504
Phone (630) 466-8200

1615 N Convent St
Ste 1
Bourbonnais, IL 60914
Phone (815) 602-8253

1100 W Veterans Pkwy
Yorkville, IL 60560
Phone (630) 236-4307

5700 Southwyck Blvd
Toledo, OH 43614

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.

Hospital & facility affiliations 3

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1972537595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W KINZIE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606426537",
            "telephone_number": "314-849-3535",
            "fax_number": "314-849-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OGDEN AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047222",
            "telephone_number": "314-849-3535",
            "fax_number": "314-849-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIL",
        "first_name": "JYOTHI",
        "middle_name": "DEEPAK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "IL",
            "license": "036108435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036108435",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00305120",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.