Individual provider Active NPI

Michael Frederick Graf, PA-C

  • Physician Assistant
  • Hoffman Estates, IL
National Provider Identifier
1003908070
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.006317 Issued in IL
Practice address
5810 Providence Dr
Hoffman Estates, IL 60192-4607
Phone
(847) 488-0941
NPI assigned
Sep 28, 2006
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.006317 IL Primary
Athletic Trainer 2255A2300X 096.004604 IL

Addresses

Primary practice location

5810 Providence Dr
Hoffman Estates, IL 60192-4607

Mailing address

9977 Woods Dr RM B-70
Skokie, IL 60077-1057
Phone (847) 663-2664

Other practice location 1

875 S Route 31
Crystal Lake, IL 61114-8190
Phone (779) 220-5500

Other identifiers 1

IdentifierTypeStateIssuer
#22OtherMTATHLETIC TRAINER

Other names 1

  • Mike Graf Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
096.004604ILMDAthletic Trainer
085.006317ILMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1003908070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR RM B-70",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "847-663-2664",
            "fax_number": "847-663-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 PROVIDENCE DR",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601924607",
            "telephone_number": "847-488-0941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 S Route 31",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "611148190",
            "country_code": "US",
            "telephone_number": "779-220-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAF",
        "first_name": "MICHAEL",
        "middle_name": "FREDERICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006317",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.004604",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINER",
            "identifier": "#22",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKE",
            "last_name": "GRAF",
            "credential": "ATC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.