Active NPI
M Scott Peckler, MD
- Surgery Physician
- Niles, IL
National Provider Identifier
1376522490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 036043322
- Practice address
- 7900 Milwaukee
Suite 222
Niles, IL 60714 - Phone
- (847) 967-9430
- Fax
- (847) 967-9218
- NPI assigned
- Jan 17, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 036043322 | IL | Primary |
Addresses
Primary practice location
7900 Milwaukee
Suite 222
Niles, IL 60714
Mailing address
7900 Milwaukee
Suite 222
Niles, IL 60714
Phone (847) 967-9430
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036043322 | Medicaid | IL |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicfhir.aurora.org/fhir/myaurora/api/fhir/dstu2/ | ||
| Direct Messaging Address | speckler251130@direct.myadvocateaurora.org | Direct |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1376522490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7900 MILWAUKEE",
"address_2": "SUITE 222",
"city": "NILES",
"state": "IL",
"postal_code": "60714",
"telephone_number": "847-967-9430",
"fax_number": "847-967-9218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7900 MILWAUKEE",
"address_2": "SUITE 222",
"city": "NILES",
"state": "IL",
"postal_code": "60714",
"telephone_number": "847-967-9430",
"fax_number": "847-967-9218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECKLER",
"first_name": "M",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-17",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036043322",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036043322",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicfhir.aurora.org/fhir/myaurora/api/fhir/dstu2/",
"affiliation": "N",
"address_1": "7900 Milwaukee",
"address_2": "Suite 222",
"city": "Niles",
"state": "IL",
"country_code": "US",
"postal_code": "60714",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "speckler251130@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "7900 Milwaukee",
"address_2": "Suite 222",
"city": "Niles",
"state": "IL",
"country_code": "US",
"postal_code": "60714",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Niles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.