Amer Galal Abdulghafoor, MSW, MS, PA-C
Individual provider Active NPI Physician Assistant · Chicago, IL
NPI 1619401718 · NPPES record last updated Aug 1, 2024
Key facts
- NPI
- 1619401718
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 085009495 (IL)
- Practice address
- 641 W 63Rd St
Chicago, IL 60621-2032 - Phone
- (773) 388-1600
- NPI assigned
- Apr 14, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Howard Brown Health Center
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230330001108 | IL | Practitioner - Physician Assistant | 6608240882 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801098845 | MI | MD | Clinical Social Worker |
| 085009495 | IL | MD | Physician Assistant |
| 085.009495 | IL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Howard Brown Health Center | Current |
Accepting new patients | |
| Howard Brown Health Center | Current |
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
641 W 63rd St
Chicago, IL 60621
Phone (312) 413-4070
4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800
Interoperability endpoints
- amer.abdulghafoor.1@3342.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801098845 | MI | |
| Medical Physician Assistant | 363AM0700X | 085.009495 | IL | |
| Physician Assistant | 363A00000X | 085009495 | IL | Yes |
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
Other providers in Chicago, IL
- Abdul Sattar MD SC
- Ahmad Abdul-Rahim
- Zainab Abdul-Rahim
- Syed Salim Abdul-Wasay
- Lin Abdulbaki
- Noor Ali Abdulhameed
- Raid Abdulla
- Ayesha Bakir Abdullah-Ewing
- Aamir Abdullah
- Larry R Abdullah
All providers in Chicago, IL · Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.