Samuel Dorevitch, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

36083148 Issued in IL

Practice address

75 Remittance Dr
Suite 1951
Chicago, IL 60675-1001

Phone

(847) 535-5917

Fax

(847) 535-5801

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013993914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5336 N LAKEWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402209",
            "telephone_number": "773-334-9029",
            "fax_number": "312-996-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 REMITTANCE DR",
            "address_2": "SUITE 1951",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751001",
            "telephone_number": "847-535-5917",
            "fax_number": "847-535-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOREVITCH",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "36083148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36083148",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremiah Lynch Dore
• Lexie Jeanne Dore, M.D.
• Patricia Diane Dore, PHD
• Gregory S. Doren, M.D.
• Tracy Dorencz
• Sarah Dorfman, LCSW
• Christopher Sean Patrick Dorgan, MD
• Danielle Dorgan, FNP-C
• Dori Peace, LLC
• Grace Diehl Dorian

• Emergency Medical Services (Emergency Medicine) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Illinois

• 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.

Verify at the official NPI Registry.