Individual provider Active NPI

Amer Galal Abdulghafoor, MSW, MS, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1619401718
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085009495 Issued in IL
Practice address
641 W 63Rd St
Chicago, IL 60621-2032
Phone
(773) 388-1600
NPI assigned
Apr 14, 2017
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801098845 MI
Medical Physician Assistant 363AM0700X 085.009495 IL
Physician Assistant 363A00000X 085009495 IL Primary

Addresses

Primary practice location

641 W 63Rd St
Chicago, IL 60621-2032

Mailing address

641 W 63Rd St
Chicago, IL 60621-2032
Phone (773) 388-1600

Other practice location 1

1542 W Devon Ave
Chicago, IL 60660-1344
Phone (773) 482-5122

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
I20230330001108 IL Practitioner - Physician Assistant 6608240882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard Brown Health CenterGroup PAC ID 1052203155, 52 clinicians

Practice addresses (Care Compare)

4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (773) 388-1600

641 W 63Rd St
Chicago, IL 60621-2032
Phone (773) 388-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
6801098845MIMDClinical Social Worker
085009495ILMDPhysician Assistant
085.009495ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Brown Health Center CurrentSince Jul 1, 2024 Accepting new patients
Howard Brown Health Center CurrentSince Jul 1, 2024 Accepting new patients
Howard Brown Health Center Past Accepting new patients
Howard Brown Health Center Past Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

641 W 63rd St
Chicago, IL 60621
Phone (312) 413-4070

Interoperability endpoints

  • Direct secure messaging: amer.abdulghafoor.1@3342.direct.athenahealth.com

Organizations & group practices 6

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": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1619401718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606212032",
            "telephone_number": "773-388-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606212032",
            "telephone_number": "773-388-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1542 W Devon Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606601344",
            "country_code": "US",
            "telephone_number": "773-482-5122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDULGHAFOOR",
        "first_name": "AMER",
        "middle_name": "GALAL",
        "credential": "MSW, MS, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801098845",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.009495",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085009495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.