Active NPI
Somchai Laowattana, MD
- Neurology Physician
- Milwaukee, WI
National Provider Identifier
1245315365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 52265-20
- Practice address
- 9200 W Wisconsin Ave
Milwaukee, WI 53226-3522 - Phone
- (414) 805-5200
- Fax
- (414) 259-0469
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 036154960 | IL | |
| Neurology Physician | 2084N0400X | 52265-20 | WI | Primary |
Addresses
Primary practice location
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Mailing address
12632 S Harlem Ave
Palos Heights, IL 60463-1428
Phone (708) 587-0000
Other practice location 1
1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451
Other practice location 2
3700 W 203rd St Ste 201
Olympia Fields, IL 60461-1182
Phone (708) 679-2120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245315365 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40762 | TX | MD | Clinical Psychologist |
| 036154960 | IL | MD | Neurology Physician |
| 52265-20 | WI | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Almasri and Associates Inc. | Current | Accepting new patients | |
| United Elite Hospitalists, LLC | Current | Accepting new patients |
Locations
12632 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 587-0000
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinic/Center
- Palos Heights, IL
- NPI 1104158286
-
- Specialist
- Palos Heights, IL
- NPI 1912279050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696982400000",
"number": "1245315365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12632 S HARLEM AVE",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604631428",
"telephone_number": "708-587-0000",
"fax_number": "708-623-7628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-5200",
"fax_number": "414-259-0469"
}
],
"practiceLocations": [
{
"address_1": "1700 W Paradise Dr",
"address_purpose": "LOCATION",
"city": "West Bend",
"state": "WI",
"postal_code": "530959795",
"country_code": "US",
"telephone_number": "262-334-3451",
"fax_number": "262-334-5321",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3700 W 203rd St Ste 201",
"address_purpose": "LOCATION",
"city": "Olympia Fields",
"state": "IL",
"postal_code": "604611182",
"country_code": "US",
"telephone_number": "708-679-2120",
"fax_number": "708-503-3230",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAOWATTANA",
"first_name": "SOMCHAI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2023-10-11",
"certification_date": "2023-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "036154960",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WI",
"license": "52265-20",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1245315365",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.