NPIMap

Organization Active NPI

Ameriwound Physicians Il LLC

  • General Practice Physician
  • Skokie, IL
National Provider Identifier
1104245893
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
AMERIWOUND PHYSICIANS IL LLC
Practice address
4957 Oakton St
#306
Skokie, IL 60077-2903
Phone
(216) 273-9800
NPI assigned
Apr 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
Samson Fixler
Title
Assistant Secretary
Phone
(216) 273-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

4957 Oakton St
#306
Skokie, IL 60077-2903

Mailing address

6150 Parkland Blvd Ste 225
Mayfield Heights, OH 44124-4103
Phone (216) 273-9800

Other identifiers 1

IdentifierTypeStateIssuer
1104245893MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140605000079 IL Part B Supplier - Clinic/Group Practice 2860616299 Receives reassigned benefits from 26 practitioners

National Provider Directory

National Provider Directory

Locations

201 W N Ave
Bensenville, IL 60105

107 N Watkins St
Cisne, IL 62823
Phone (618) 673-2177

850 E 2nd St
El Paso, IL 61738
Phone (309) 527-2700

404 Brookview Dr
Farmer City, IL 61842
Phone (309) 928-2118

1650 Old Indian Town Rd
Henry, IL 61537
Phone (309) 364-3905

1201 N Alton St
Lebanon, IL 62254
Phone (618) 537-4401

900 W Race St
Ridgway, IL 62979
Phone (618) 272-8831

3856 Oakton St
Fl 2
Skokie, IL 60076
Phone (847) 933-9200

5800 Landerbrook Dr
Ste 100
Mayfield Hts, OH 44124
Phone (323) 800-2799

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1104245893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 PARKLAND BLVD STE 225",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441244103",
            "telephone_number": "216-273-9800",
            "fax_number": "216-273-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4957 OAKTON ST",
            "address_2": "#306",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772903",
            "telephone_number": "216-273-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERIWOUND PHYSICIANS IL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-10",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "FIXLER",
        "authorized_official_first_name": "SAMSON",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "216-273-9800"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104245893",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.

Verify at the official NPI Registry.