Individual provider Active NPI

Anwar Alan Androun, PA-C

  • Physician Assistant
  • Tinley Park, IL
National Provider Identifier
1619856010
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7540 163Rd St
Tinley Park, IL 60477-1549
Phone
(708) 979-4985
NPI assigned
Aug 29, 2025
Last updated
Aug 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

7540 163Rd St
Tinley Park, IL 60477-1549

Mailing address

7540 163Rd St
Tinley Park, IL 60477-1549
Phone (708) 979-4985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20260310003483 IA Practitioner - Physician Assistant 8628551413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Iowa Mercy ClinicsGroup PAC ID 7810809076, 304 clinicians

Practice addresses (Care Compare)

1000 4TH St SW
Mason City, IA 50401-2800

1421 4TH St SW
Mercyone North Iowa Dermatology Care
Mason City, IA 50401-2736
Phone (641) 428-2080

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Iowa Mercy Clinics CurrentSince Feb 9, 2026 Accepting new patients
North Iowa Mercy Clinics CurrentSince Feb 9, 2026 Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1619856010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7540 163RD ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771549",
            "telephone_number": "708-979-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 163RD ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771549",
            "telephone_number": "708-979-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDROUN",
        "first_name": "ANWAR",
        "middle_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.