Provider Demographics
NPI:1265831101
Name:SOUTHWEST PHYSICIANS ASSOCIATES, S. C.
Entity Type:Organization
Organization Name:SOUTHWEST PHYSICIANS ASSOCIATES, S. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMDI
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHILFEH
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:708-200-6615
Mailing Address - Street 1:10749 CHERRYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-3701
Mailing Address - Country:US
Mailing Address - Phone:708-200-6615
Mailing Address - Fax:708-598-3304
Practice Address - Street 1:2955 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2409
Practice Address - Country:US
Practice Address - Phone:708-200-6615
Practice Address - Fax:708-598-3304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-16
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036110790207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty