KETAN R PATEL (NPI# 1114326956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114326956 |
| Entity Type | Organization |
| Organization Name | KETAN R PATEL |
| Other Organization Name | KETAN R PATEL |
| Practice Address |
530 Park Ave E Suite 101 Princeton IL 61356-3901 |
| Practice Telephone | 8158721221 |
| Practice Fax Number | 8158722304 |
| Mailing Telephone | 8158721221 |
| Mailing Fax Number | 8158722304 |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2014-08-18 |
| Authorized Official Name | DR. KETAN R PATEL (SELF EMPLOYED) |
| Authorized Official Telephone | 8158721221 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036083069 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036083069 | 05 | |
| IL | NPI | 1114910528 | 01 |
| Other Name | Type Code |
|---|---|
| ketan r patel | Doing Business As Name - Organization |
| Street Address |
530 PARK AVE E SUITE 101 |
| City | PRINCETON |
| State | IL |
| Zip Code | 61356-3901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021308 | Julia Rackley Perry Memorial Hospital | General Acute Care Hospital | 530 Park Ave E, Princeton, IL 61356-3901 | 2005-05-23 |
| 1427529577 | Ashley Kannenberg | Dietitian, Registered | 530 Park Ave E, Princeton, IL 61356-2598 | 2018-12-16 |
| 1689126799 | Jo A Muller | Nurse Practitioner | 530 Park Ave E, Ste 207, Princeton, IL 61356-3901 | 2016-10-25 |
| 1578940524 | Jennifer Hoffman | Nurse Practitioner | 530 Park Ave E, Princeton, IL 61356-3901 | 2015-04-29 |
| 1922411602 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E, Princeton, IL 61356-3901 | 2014-06-10 |
| 1942551312 | Jenny Gaworski | Nurse Practitioner | 530 Park Ave E, Princeton, IL 61356-3901 | 2012-09-26 |
| 1619231719 | Victoria Jeannine Anderson | Physical Therapy Assistant | 530 Park Ave E, Princeton, IL 61356-2598 | 2012-07-03 |
| 1710241286 | Jacquelyn Johnson | Occupational Therapist | 530 Park Ave E, Princeton, IL 61356-3901 | 2012-06-29 |
| 1023372869 | Debra K Austin | Physical Therapist | 530 Park Ave E, Princeton, IL 61356-2598 | 2012-06-26 |
| 1609138858 | Jennifer Lee Heckroth | Physical Therapist | 530 Park Ave E, Princeton, IL 61356-3901 | 2012-06-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548698558 | Shelley Gorenz | Counselor | 1009 S. Main St., Princeton, IL 61356 | 2013-10-30 |
| 1780016626 | Jennifer Phillips | Pharmacist | 610 N. Main St., Princeton, IL 61356 | 2013-08-02 |
| 1477848521 | Princeton Prompt Care LLC | Clinic/Center | 2128 North Main Street, Princeton, IL 61356 | 2011-06-16 |
| 1306014196 | Lifefit Physical Rehab, Ltd. | Clinic/Center | 1225 N. Sixth St., Princeton, IL 61356 | 2008-02-14 |
| 1568669778 | Hawthorne Inn Supportive Living Facility | Assisted Living Facility | 136 N. Sixth St., Princeton, IL 61356 | 2007-06-29 |
| 1720209240 | Michelle Lee Mortensen | Music Therapist | 816 S. First St., Princeton, IL 61356 | 2007-05-01 |
| 1073733465 | Jarred Allen Farrell | Chiropractor | 682 East Peru Street, Princeton, IL 61356 | 2007-04-26 |
| 1952488397 | Donald R Marion | Optometrist | 2 Park Avenue West, Princeton, IL 61356 | 2006-11-01 |
| 1427138247 | Bruce Waldo Shriver | Dentist | 422 E Peru St, Princeton, IL 61356 | 2006-10-16 |
| 1871689612 | Jason A Monroe | Dentist | 334 Backbone Rd East, Princeton, IL 61356 | 2006-10-05 |
| Find all providers in zip 61356 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033681432 | Danielle Coppola | Internal Medicine | 2 Cleveland Ln, Princeton, NJ 08540-3050 | 2018-12-23 |
| 1174059885 | Oscar Alberto Perez Gutierrez | Internal Medicine | 3225 Sayre Dr, Princeton, NJ 08540-5868 | 2017-05-02 |
| 1982011995 | Prapti Praful Kuber | Internal Medicine | 2 Eagles Pass, Princeton, NJ 08540-8813 | 2014-07-22 |
| 1235487869 | Simon D. Murray, Md LLC | Internal Medicine | 727 State Rd Ste 2, Princeton, NJ 08540-1444 | 2012-08-29 |
| 1629332812 | Jae Young Lee | Internal Medicine | 419 N. Harrison St, Princeton, NJ 08540-4089 | 2012-07-02 |
| 1396016960 | Kent Stewart Allenby | Internal Medicine | 42 Christopher Dr, Princeton, NJ 08540-2321 | 2012-01-13 |
| 1073821898 | David R Barile Md LLC | Internal Medicine | 30 Boudinot St, Princeton, NJ 08540-3008 | 2010-09-14 |
| 1043538184 | Princeton Premier Medicine, LLC | Internal Medicine | 281 Witherspoon Street, Suite 220, Princeton, NJ 08542 | 2010-05-13 |
| 1972825057 | Tracey J. Moreno, Md, LLC | Internal Medicine | 601 Ewing St Ste C13, Princeton, NJ 08540-2758 | 2010-02-17 |
| 1487984803 | Constance Monroe Winslow | Internal Medicine | 283 Mount Lucas Rd, Princeton, NJ 08540-2714 | 2010-01-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.