Individual provider Active NPI

Abdullah Bin Mahfodh, M.D.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1033640198
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036152446 Issued in IL
Practice address
1501 S California Ave
Chicago, IL 60608-1732
Phone
(773) 542-2000
NPI assigned
Mar 21, 2017
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Psychiatry Physician 2084P0800X 036152446 IL Primary

Addresses

Primary practice location

1501 S California Ave
Chicago, IL 60608-1732

Mailing address

26460 Network PL
Chicago, IL 60673-2776
Phone (773) 257-2820

Other practice location 1

1000 E 24th St
Kansas City, MO 64108-2776
Phone (816) 512-7481

Other practice location 2

515 Valley St Ste 203
Maplewood, NJ 07040-4300
Phone (908) 663-2929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210303002734 IL Practitioner - Psychiatry 3577833094 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stepping Stones of Rockford, IncGroup PAC ID 9739283748, 3 clinicians

Practice addresses (Care Compare)

706 N Main St
Rockford, IL 61103-6904
Phone (815) 963-0683

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036152446ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation CurrentSince Mar 1, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Sep 1, 2021 Accepting new patients
Heritage Behavioral Health Center, Inc. CurrentSince Nov 29, 2023 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Stepping Stones of Rockford, Inc Psychiatry CurrentSince Nov 10, 2024 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Heritage Behavioral Health Center Inc. CurrentSince Nov 29, 2023 Accepting new patients
Mount Sinai Community Foundation CurrentSince Mar 1, 2021 Accepting new patients
Suburban Behavioral Health Inc Psychiatry Past Accepting new patients

Locations

1501 S California Ave
Chicago, IL 60608
Phone (773) 257-6770

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

9532 Eagle Way
Chicago, IL 60678

151 N Main St
Decatur, IL 62523
Phone (217) 420-4776

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

706 N Main St
Rockford, IL 61103

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1033640198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26460 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606732776",
            "telephone_number": "773-257-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081732",
            "telephone_number": "773-542-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E 24th St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082776",
            "country_code": "US",
            "telephone_number": "816-512-7481",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Valley St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "NJ",
            "postal_code": "070404300",
            "country_code": "US",
            "telephone_number": "908-663-2929",
            "fax_number": "908-219-6213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIN MAHFODH",
        "first_name": "ABDULLAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036152446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.