DR. MAHENDRAGOUDA PATIL (NPI# 1356567978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356567978 |
| Entity Type | Individual |
| Full Name | DR. MAHENDRAGOUDA PATIL |
| Credential | M.D. |
| Practice Address |
11600 S Kedzie Ave Merrionette Park IL 60803-6302 |
| Mailing Address |
1225 S Plymouth Ct Chicago IL 60605-2719 |
| Practice Telephone | 7085972173 |
| Practice Fax Number | 7085972315 |
| Mailing Telephone | 7085972173 |
| Mailing Fax Number | 7085972315 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 208D00000X | General Practice | IL | Allopathic & Osteopathic Physicians | |
| X | 207PH0002X |
Emergency Medicine Specialization: Hospice and Palliative Medicine |
IL | Allopathic & Osteopathic Physicians | |
| X | 207QH0002X |
Family Medicine Specialization: Hospice and Palliative Medicine |
IL | Allopathic & Osteopathic Physicians |
| Street Address |
11600 S KEDZIE AVE |
| City | MERRIONETTE PARK |
| State | IL |
| Zip Code | 60803-6302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003809674 | Mri Associates of Illinois Sc | Radiology | 11600 S Kedzie Ave, Merrionette Park, IL 60803-6302 | 2005-08-29 |
| 1558996090 | Lauren Ellis | Nurse Practitioner | 11600 S Kedzie Ave, Merrionette Park, IL 60803-6307 | 2020-03-05 |
| 1396249520 | Jenny Rosillo Macaso | Pharmacist | 11600 S Kedzie Ave, Merrionette Park, IL 60803-6307 | 2018-03-21 |
| 1598270522 | Garden Family Pharmacy Inc | Pharmacy | 11600 S Kedzie Ave, Suite E, Merrionette Park, IL 60803-6307 | 2017-12-13 |
| 1952849754 | Amy Gill | Nurse Practitioner | 11600 S Kedzie Ave, Merrionette Park, IL 60803-6307 | 2017-02-01 |
| 1750631727 | Erin Dana Drever | Internal Medicine | 11600 S Kedzie Ave, Merrionette Park, IL 60803-6307 | 2012-09-17 |
| 1194086280 | Industrial Physical Therapy, Inc | Clinic/Center | 11600 S Kedzie Ave, Merrionette Park, IL 60803-6307 | 2012-06-05 |
| 1710252465 | Sarwat Shaheen | Family Medicine | 11600 S Kedzie Ave, Merrionette Park, IL 60803-6307 | 2012-03-14 |
| 1447582796 | Neighborhood Pharmacy Inc | Pharmacy | 11600 S Kedzie Ave, Merrionette Park, IL 60803-6307 | 2010-02-10 |
| 1902130263 | James & Huddleston Center for Pain, S.c. | Clinic/Center | 11600 S Kedzie Ave, Merrionette Park, IL 60803-6307 | 2009-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699173013 | American Medical Lab, Ltd | Clinical Medical Laboratory | 5130 W 125th Pl, American Medical Lab, Alsip, IL 60803 | 2014-12-17 |
| 1225387574 | A Touch of Class Dentistry II | Dentist | 12033 S. Pulaski Road, Alsip, IL 60803 | 2012-08-31 |
| 1841431657 | George P. Danos Inc | Dentist | 5101 W 111th St, Alsip, IL 60803 | 2009-03-09 |
| 1194898114 | Vital Rehabilitation & Physical Therapy Inc | Clinic/Center | 11600 S Kedzie, Merrionette Park, IL 60803 | 2006-11-16 |
| 1841203650 | Alsip Dental Arts PC | Dentist | 11107 South Lawler, Alsip, IL 60803 | 2006-08-14 |
| 1477500932 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 12001 S Pulaski Rd, Alsip, IL 60803 | 2006-05-30 |
| 1013961044 | Arbor Centers for Eye Care | Technician/Technologist | 11600 South Kedzie Ave, Merrionette Park, IL 60803 | 2006-05-22 |
| 1467064360 | Yash Desai | Pharmacist | 12290 S Pulaski Rd, Alsip, IL 60803 | 2020-08-20 |
| 1609293539 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 3243 W 115th St, Merrionette Park, IL 60803 | 2014-03-28 |
| 1114357092 | Abdul Hussein Darki | Pediatrics | 11808 S Pulaski Rd, Alsip, IL 60803 | 2013-11-14 |
| Find all providers in zip 60803 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1306465786 | Brightlife Regenerative Medical Clinic Lombard Sc | General Practice | 442 E Roosevelt Rd, Lombard, IL 60148-4630 | 2020-04-15 |
| 1851920524 | Sahens Mezidor | General Practice | 228 Ridge Ave Apt G, Evanston, IL 60202-6409 | 2020-04-05 |
| 1447881487 | Tyrian Healthcare Solutions, LLC | General Practice | 2120 W Heading Ave, West Peoria, IL 61604-5138 | 2020-01-29 |
| 1598302077 | Enhance Medical LLC | General Practice | 1193 N Gary Ave, Carol Stream, IL 60188-9423 | 2019-12-04 |
| 1164067054 | League Corp. | General Practice | 515 N State St Fl 8, Chicago, IL 60654-9102 | 2019-11-14 |
| 1679129977 | Chronic Care Solutions LLC | General Practice | 3050 W Columbia Ave, Chicago, IL 60645-4006 | 2019-08-13 |
| 1205393972 | Midwest Medical LLC | General Practice | 2001 Midwest Rd Ste Ll22, Oak Brook, IL 60523-1316 | 2019-02-28 |
| 1306311725 | Genesis Integrative Medicine LLC | General Practice | 1881 S Randall Rd Ste C, Geneva, IL 60134-2532 | 2018-10-11 |
| Find all providers with the same taxonomy | ||||
| City | MERRIONETTE PARK |
| Zip Code | 60803 |
Please comment or provide details below to improve the information on DR. MAHENDRAGOUDA PATIL.
| 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.