Individual provider Active NPI

Samah Raheem, DO

  • Physical Medicine & Rehabilitation Physician
  • Wheaton, IL
National Provider Identifier
1316634454
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
125.084654 Issued in IL
Practice address
26W171 Roosevelt Rd
Wheaton, IL 60187-6002
Phone
(630) 362-9993
NPI assigned
Apr 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 125.084654 IL Primary

Addresses

Primary practice location

26W171 Roosevelt Rd
Wheaton, IL 60187-6002

Mailing address

2318 River Woods Dr
Naperville, IL 60565-6352
Phone (630) 362-9993

Other practice location 1

520 S 7th St
Vincennes, IN 47591-1038
Phone (812) 885-8520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250213000225 IN Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Physical Medicine and Rehabilitation 8527426477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125.084654ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sraheem233426@direct.deaconess.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1316634454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 RIVER WOODS DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605656352",
            "telephone_number": "630-362-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26W171 ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601876002",
            "telephone_number": "630-362-9993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 S 7th St",
            "address_purpose": "LOCATION",
            "city": "Vincennes",
            "state": "IN",
            "postal_code": "475911038",
            "country_code": "US",
            "telephone_number": "812-885-8520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHEEM",
        "first_name": "SAMAH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "125.084654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.