PURVI GABHAWALA (AGNP) – Adult Health Nurse Practitioner, NPI 1104589209

PURVI GABHAWALA (AGNP) is a healthcare provider. based in Bloomingdale, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials AGNP. They hold a License No. 209024148 (IL). The NPI Number for PURVI GABHAWALA (AGNP) is 1104589209

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
PURVI GABHAWALA (AGNP)
NPI
1104589209
Phone
(630) 894-8018
Address
473 W Army Trail Rd
Enumeration Date
16 October 2021
Last Update Date
16 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6308948018
Graduation Year
2021 (5 years ago)
PAC ID
5991178576
Group Practice PAC ID
4486847498
Professional Enrollment ID
I20230301001724
Address ID
IL601082674BL473XXRDXX517
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for PURVI GABHAWALA (AGNP)

  • 473 W Army Trail Rd

    Bloomingdale, IL 601082674

    Phone: (630) 894-8018

    Type: Location

  • 1112 SANDHURST LN

    CAROL STREAM, IL 601884348

    Phone: (631) 605-2916

    Type: Mailing

  • 150 N RIVER RD

    DES PLAINES, IL 600161272

    Phone: (847) 290-1300

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 36 Open Payments records for all available years, with a total value of $634.

Total Amount is formed as General ($634) + Research ($0) + Ownership ($0) = $634.

Last reported payment date: 2024-12-23 • Largest payer in this snapshot: Lilly USA, LLC ($229).

Total Amount

$634

General + Research + Ownership

Payments

36

Total payment records

General Amount

$634

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-23

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-03-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230301001724INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60108)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486847498View full group profile
NameSpecialtyState
Internal MedicineIL
Internal MedicineIL
Internal Medicine, HospitalistIL
Physical Therapist In Private PracticeIL
Family PracticeIL
Internal MedicineIL

Reviews

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Frequently asked questions

What is the 10-digit NPI for PURVI GABHAWALA (AGNP)?
PURVI GABHAWALA (AGNP) — NPI 1104589209 — is the standard way to identify this listing.
Can I rely on PURVI GABHAWALA (AGNP) being an active provider?
As of the registry snapshot, PURVI GABHAWALA (AGNP) is marked active.
What taxonomy line describes PURVI GABHAWALA (AGNP)?
For research purposes, treat PURVI GABHAWALA (AGNP) as Adult Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does PURVI GABHAWALA (AGNP) serve?
PURVI GABHAWALA (AGNP)'s listing highlights Bloomingdale, Illinois; more addresses can appear in NPPES.
Why does PURVI GABHAWALA (AGNP) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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