Healthcare Provider Details

I. General information

NPI: 1346985041
Provider Name (Legal Business Name): BINDIYA PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 W CONGRESS PKWY STE 1121
CHICAGO IL
60612-3809
US

IV. Provider business mailing address

1325 COMMUNITY MEMORIAL DR
LA GRANGE IL
60525-2659
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-2852
  • Fax: 312-563-3701
Mailing address:
  • Phone: 708-245-8900
  • Fax: 708-245-5721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number125082250
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number036.172203
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: