Individual provider Active NPI

Abraham Jose Chourio, SA-C

  • Surgical Physician Assistant
  • Mokena, IL
National Provider Identifier
1043045453
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
238000823 Issued in IL
Practice address
18761 Chestnut CT
Mokena, IL 60448-9501
Phone
(786) 448-9020
NPI assigned
Sep 5, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 238000823 IL Primary

Addresses

Primary practice location

18761 Chestnut CT
Mokena, IL 60448-9501

Mailing address

3002 Anton Dr
Aurora, IL 60504-6606
Phone (689) 282-7953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
238000823ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proassisting, Inc Surgical CurrentSince Sep 8, 2024 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1043045453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 ANTON DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605046606",
            "telephone_number": "689-282-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18761 CHESTNUT CT",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489501",
            "telephone_number": "786-448-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOURIO",
        "first_name": "ABRAHAM",
        "middle_name": "JOSE",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "238000823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.