Active NPI
Ami N. Mikhail, PA
- Surgical Physician Assistant
- Evanston, IL
National Provider Identifier
1679774731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- Practice address
- 1000 Central St
Department of Orthopaedic Surgery, Ste 880
Evanston, IL 60201-1777 - Phone
- (847) 570-2825
- Fax
- (847) 733-5060
- NPI assigned
- May 29, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | IL | Primary |
Addresses
Primary practice location
1000 Central St
Department of Orthopaedic Surgery, Ste 880
Evanston, IL 60201-1777
Mailing address
2650 Ridge Ave
Evanston Hospital
Evanston, IL 60201-1718
Phone (847) 570-1206
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085-002279 | IL | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Spine and Sports | Current | Accepting new patients | |
| Endeavor Health Medical Group | Past | Accepting new patients |
Locations
9913 N 95th St
Scottsdale, AZ 85258
Phone (480) 860-8998
1025 E Broadway Rd
Tempe, AZ 85282
Phone (480) 829-0217
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 and National Provider Directory roles.
-
- Pain Medicine (Physical Medicine & Rehabilitation) Physician
- Glendale, AZ
- NPI 1689993552
-
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679774731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE",
"address_2": "EVANSTON HOSPITAL",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011718",
"telephone_number": "847-570-1206",
"fax_number": "847-570-1248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 CENTRAL ST",
"address_2": "DEPARTMENT OF ORTHOPAEDIC SURGERY, STE 880",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011777",
"telephone_number": "847-570-2825",
"fax_number": "847-733-5060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKHAIL",
"first_name": "AMI",
"middle_name": "N.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.