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Physician Compare National (NPI:1487768917)

HEALTHCARE PROVIDER: JAGANNATH PATIL MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1487768917
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 6709868953
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20101008001150
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name PATIL
Individual professional last name
Provider First Name JAGANNATH
Individual professional first name
Provider Middle Name J
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1974
Individual professional's medical school graduation year
Primary Specialty NEUROLOGY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 1456256874
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 98
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 4 MEMORIAL DR
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 210
Group Practice or individual's line 2 address
City ALTON
Group Practice or individual's city
State IL
Group Practice or individual's state
Zip Code 620026751
Group Practice or individual's zip code (9 digits when available)
Phone Number 6184635905
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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