Individual provider Active NPI

Ahmad M Almawaldi, NP

  • Nurse Practitioner
  • Lisle, IL
National Provider Identifier
1366139537
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.027868 Issued in IL
Practice address
550 Warrenville Rd Ste 200
Lisle, IL 60532-4311
Phone
(872) 250-3618
NPI assigned
Apr 19, 2023
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.027868 IL Primary
Registered Nurse 163W00000X 041467177 IL

Addresses

Primary practice location

550 Warrenville Rd Ste 200
Lisle, IL 60532-4311

Mailing address

641 E Pershing Rd Unit 202
Chicago, IL 60653-1977

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231201001001 IL Practitioner - Nurse Practitioner 9436507423 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Applebaum Physiatry PLLCGroup PAC ID 8729453436, 141 clinicians

Practice addresses (Care Compare)

1311 Parkview Ave
Rockford, IL 61107-1818
Phone (815) 399-8832

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.027868ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbe Senior Medical Illinois PC CurrentSince Oct 30, 2023 Accepting new patients
Applebaum Physiatry PLLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

225 W Washington St
Ste 1500
Chicago, IL 60606
Phone (312) 776-2422

225 W Washington St
Ste 1700
Chicago, IL 60606
Phone (234) 200-4220

5061 N Pulaski Rd
Chicago, IL 60630
Phone (773) 478-1186

550 Warrenville Rd
Ste 200
Lisle, IL 60532
Phone (312) 776-2422

550 Warrenville Rd
Ste 300
Lisle, IL 60532
Phone (630) 725-7204

1311 Parkview Ave
Rockford, IL 61107
Phone (815) 395-8700

128 S East St
Unit 1109
Crown Point, IN 46308

Organizations & group practices 2

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": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1366139537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 E PERSHING RD UNIT 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606531977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WARRENVILLE RD STE 200",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605324311",
            "telephone_number": "872-250-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALMAWALDI",
        "first_name": "AHMAD",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.027868",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041467177",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.