Purvi Gabhawala, AGNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209024148 Issued in IL

Practice address

150 N River Rd
Des Plaines, IL 60016-1272

Phone

(847) 290-1300

NPI assigned

Oct 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Medical Care SCGroup PAC ID 4486847498, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Northwest Medical Care SC

  • Internal Medicine Physician
  • Bloomingdale, IL
  • NPI 1447277447

  IL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1634342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634342400000",
    "number": "1104589209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 SANDHURST LN",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601884348",
            "telephone_number": "631-605-2916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N RIVER RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161272",
            "telephone_number": "847-290-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "473 W Army Trail Rd",
            "address_purpose": "LOCATION",
            "city": "Bloomingdale",
            "state": "IL",
            "postal_code": "601082674",
            "country_code": "US",
            "telephone_number": "630-894-8018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GABHAWALA",
        "first_name": "PURVI",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-16",
        "last_updated": "2021-10-16",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209024148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Funwal LLC
• Dagmara Furgal
• Sergey Furmanov, MD
• FZ Medical Group Inc
• G & F Consulting Inc
• Carlo Frank Gaglio, PHARMD
• John Galasso Jr., M.D.
• Marcin Galica
• Mary Gallagher, MS, LPC, CADC
• Shantelle Gallimore

• All providers in Des Plaines, IL
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.