SHAKUNTALA SACHIN PATIL (NPI# 1437599867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437599867 |
| Entity Type | Individual |
| Full Name | SHAKUNTALA SACHIN PATIL |
| Credential | M.D |
| Practice Address |
611 W Park St Carle Forum Ll Urbana IL 61801-2500 |
| Practice Telephone | 2173833110 |
| Mailing Telephone | 2173833110 |
| Enumeration Date | 2013-06-29 |
| Last Update Date | 2013-06-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0000X |
Internal Medicine Specialization: Adolescent Medicine |
125062971 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
611 W PARK ST CARLE FORUM LL |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831193416 | Mark L Saxton | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2005-06-10 |
| 1083214514 | Karissa Nelson | Physical Therapist | 611 W Park St, Urbana, IL 61801-2529 | 2020-10-26 |
| 1720698756 | Justin Matthew Felix | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-08-04 |
| 1033729306 | Patricia Fairchild | Occupational Therapist | 611 W Park St, Urbana, IL 61801-2529 | 2020-08-03 |
| 1851909782 | Shruti Agarwal | Internal Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-16 |
| 1396363321 | Muhammad Umair Rana | Internal Medicine | 611 W Park St, Urbana, IL 61801 | 2020-07-07 |
| 1740807817 | Salma Malik | Internal Medicine | 611 W Park St, Urbana, IL 61801 | 2020-07-06 |
| 1477171536 | Audrey T Lam | Internal Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-06 |
| 1255959318 | Corbin Reid Mah | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-07-06 |
| 1093332652 | Knika Sethi | Surgery | 611 W Park St, Urbana, IL 61801-2529 | 2020-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 207RA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Adolescent Medicine |
| An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| 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 |
|---|---|---|---|---|
| 1447446257 | Farah Tazeen | Internal Medicine | 1 S 161 Summit Ave., Oak Brook Terrace, IL 60181-3904 | 2007-09-15 |
| 1114142643 | Christina B Nulty | Internal Medicine | 912 N Elmwood Ave, Peoria, IL 61625-0001 | 2007-04-17 |
| 1679665020 | Lynessa A Alonso | Internal Medicine | 10 Saint Clare Ct, Washington, IL 61571-9239 | 2006-09-29 |
| 1447273859 | Samir Shah M.d.s.c | Internal Medicine | 3560 W 95th St, Evergreen Park, IL 60805-2107 | 2006-07-26 |
| 1194248914 | Mohamed Ihtesham Shaji | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2017-07-24 |
| 1679969182 | Greg D Ewert Md Sc | Internal Medicine | 200 S Michigan Ave, Suite 805, Chicago, IL 60604-2402 | 2015-04-10 |
| 1487993911 | Eilis Ryan | Internal Medicine | 6500 W 65th St, Chicago, IL 60638-4962 | 2013-02-04 |
| 1831496322 | Capital Health Inc | Internal Medicine | 7107 W Belmont Ave, Suite 8, Chicago, IL 60634-4688 | 2011-02-17 |
| 1356507834 | Woodridgeclinic S.c | Internal Medicine | 805 S Main St, Lombard, IL 60148-3300 | 2008-08-04 |
| 1043338189 | Sarah Bush Lincoln Health Center | Internal Medicine | 200 Richmond Ave E, Mattoon, IL 61938-4652 | 2007-03-27 |
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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.