# KAVITA SHANKER-PATEL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1124384789
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 036138106 | IL | — |
| 207Q00000X | Family Medicine Physician | 125061830 | IL | — |
| 207Q00000X | Family Medicine Physician | 2022-01815 | NC | Yes |

## Other

- **Enumeration date:** 04/09/2012
- **Last updated:** 10/03/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 036138106 | MEDICAID | IL |
| 01 | — | 920540 | MEDICARE PTAN (GROUP) | IL |
| 01 | — | F400250954 | MEDICARE PTAN (INDIVIDUAL) | IL |