Active NPI
Agape Family Wound Care LLC
- Medical Physician Assistant
- Chicago, IL
National Provider Identifier
1770362196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- Legal business name
- AGAPE FAMILY WOUND CARE LLC
- Practice address
- 4001 W Devon Ave Ste 210
Chicago, IL 60646-4537 - Phone
- (773) 983-6204
- NPI assigned
- Sep 25, 2023
- Last updated
- May 30, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Abdul Moghni
- Title
- President
- Phone
- (773) 983-6204
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | NU | Primary |
Addresses
Primary practice location
4001 W Devon Ave Ste 210
Chicago, IL 60646-4537
Mailing address
5800 S Park Ave
Morton Grove, IL 60053-3021
Phone (773) 983-6204
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Surgical Physician Assistant
- Chicago, IL
- NPI 1437541125
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695600000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1748563200000",
"number": "1770362196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5800 S PARK AVE",
"city": "MORTON GROVE",
"state": "IL",
"postal_code": "600533021",
"telephone_number": "773-983-6204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 W DEVON AVE STE 210",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606464537",
"telephone_number": "773-983-6204"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AGAPE FAMILY WOUND CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-09-25",
"last_updated": "2025-05-30",
"certification_date": "2025-05-30",
"status": "A",
"authorized_official_last_name": "MOGHNI",
"authorized_official_first_name": "ABDUL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "773-983-6204"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.