NPIMap

Organization Active NPI

Southwest Physicians Associates, S. C.

  • Family Medicine Physician
  • Evergreen Park, IL
National Provider Identifier
1265831101
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036110790 Issued in IL
Legal business name
SOUTHWEST PHYSICIANS ASSOCIATES, S. C.
Practice address
2955 W 95TH St
Evergreen Park, IL 60805-2409
Phone
(708) 200-6615
Fax
(708) 598-3304
NPI assigned
Aug 16, 2014
Last updated
Oct 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Authorized official

Name
Dr. Hamdi M Khilfeh, M. D.NPI 1558477661
Title
Medical Director
Phone
(708) 200-6615

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 036110790 IL Primary

Addresses

Primary practice location

2955 W 95TH St
Evergreen Park, IL 60805-2409

Mailing address

10749 Cherrywood Dr
Palos Park, IL 60464-3701
Phone (708) 200-6615

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL H.HMEDICALVENTURE@YAHOO.COM Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141003000398 IL Part B Supplier - Clinic/Group Practice 2466672001 Receives reassigned benefits from 19 practitioners
Practice locations: Chicago, IL; Evergreen Park, IL; Harvey, IL; Oak Forest, IL; Orland Park, IL

National Provider Directory

National Provider Directory

Locations

71 W 156th St
Ste 212
Harvey, IL 60426
Phone (708) 339-6660

6300 159th St
Ste C
Oak Forest, IL 60452
Phone (708) 535-3300

9900 Southwest Hwy
#9903
Oak Lawn, IL 60453

12050 S Harlem Ave
Ste B
Palos Heights, IL 60463
Phone (708) 361-5788

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1408147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1265831101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10749 CHERRYWOOD DR",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604643701",
            "telephone_number": "708-200-6615",
            "fax_number": "708-598-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052409",
            "telephone_number": "708-200-6615",
            "fax_number": "708-598-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PHYSICIANS ASSOCIATES, S. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-16",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "KHILFEH",
        "authorized_official_first_name": "HAMDI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "708-200-6615",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036110790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "H.HMEDICALVENTURE@YAHOO.COM",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10749 Cherrywood Dr",
            "city": "Palos Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604643701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.