Organization Active NPI

Scott Palmer, M.D., LLC

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1154632297
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036074836 Issued in IL
Legal business name
SCOTT PALMER, M.D., LLC
Practice address
1611 W Harrison St
2ND Floor
Chicago, IL 60612-4861
Phone
(312) 942-4040
NPI assigned
Jun 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Authorized official

Name
Dr. Scott B Palmer, M.D.NPI 1144245994
Title
Owner
Phone
(312) 942-4040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036074836 IL Primary

Addresses

Primary practice location

1611 W Harrison St
2ND Floor
Chicago, IL 60612-4861

Mailing address

1611 W Harrison St
2ND Floor
Chicago, IL 60612-4861
Phone (312) 942-4040

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110127000734 IL Part B Supplier - Clinic/Group Practice 5092994624 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

1611 W Harrison St
Fl 2
Chicago, IL 60612
Phone (312) 942-4040

1725 W Harrison St
Ste 105
Chicago, IL 60612
Phone (312) 942-4040

1725 W Harrison St
Ste 318
Chicago, IL 60612
Phone (312) 942-6647

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1154632297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-942-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-942-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT PALMER, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-23",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-942-4040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036074836",
            "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 Jun 23, 2010; 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.