Basic Information
Provider Information
NPI: 1376030528
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: RUSHIL
MiddleName: G.
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
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Mailing Information
Address1: 2650 RIDGE AVE.
Address2: IM HOSPITALISTS STE 4210
City: EVANSTON
State: IL
PostalCode: 60201
CountryCode: US
TelephoneNumber: 8475701010
FaxNumber: 8477335108
Practice Location
Address1: 2650 RIDGE AVE.
Address2: IM HOSPITALISTS STE 4210
City: EVANSTON
State: IL
PostalCode: 60201
CountryCode: US
TelephoneNumber: 8475701010
FaxNumber: 8477335108
Other Information
ProviderEnumerationDate: 04/13/2018
LastUpdateDate: 07/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X036157240ILN Allopathic & Osteopathic PhysiciansInternal Medicine 
390200000X KSN Student, Health CareStudent in an Organized Health Care Education/Training Program 
208M00000X036157240ILY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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