Individual provider Active NPI

Amer Khairallah

  • Physician Assistant
  • Palos Heights, IL
National Provider Identifier
1639842743
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085009852 Issued in IL
Practice address
12632 S Harlem Ave
Palos Heights, IL 60463-1428
Phone
(708) 587-0000
NPI assigned
Jul 26, 2021
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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 085009852 IL Primary

Addresses

Primary practice location

12632 S Harlem Ave
Palos Heights, IL 60463-1428

Mailing address

12632 S Harlem Ave
Palos Heights, IL 60463-1428
Phone (708) 543-0162

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
I20231127000166 IL Practitioner - Physician Assistant 7517315922 Reassigns benefits to 5 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
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1653 W Congress Pkwy
Chicago, IL 60612-3833

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

2800 W 95TH St
Evergreen, IL 60805-2701
Phone (708) 422-6200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Apr 9, 2025 Accepting new patients
Dr. Almasri and Associates Inc. CurrentSince Sep 5, 2023 Accepting new patients
Cook County CurrentSince Nov 14, 2024 Accepting new patients
Cook County CurrentSince Nov 14, 2024 Accepting new patients

Locations

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

75 Remittance Dr
Dept 1611
Chicago, IL 60675

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

12632 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 587-0000

Organizations & group practices 8

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 3

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": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1639842743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12632 S HARLEM AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631428",
            "telephone_number": "708-543-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12632 S HARLEM AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631428",
            "telephone_number": "708-587-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIRALLAH",
        "first_name": "AMER",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-26",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085009852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.