Samuel Moltz, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-114262 Issued in IL

Practice address

1847 Oak St
Northfield, IL 60093-3013

Phone

(847) 881-2861

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1376655928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1847 OAK ST",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933013",
            "telephone_number": "312-929-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 OAK ST",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933013",
            "telephone_number": "847-881-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLTZ",
        "first_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-114262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miroslaw Walo, MD SC (Neuropsychiatric Health Connection)
• Emily Misar
• Ashley Mittelman, LCSW
• Alpa Vaghasiya Modi, DO
• Barbara Mokrzycka-Pys, D.C.
• Mona H Berman Ma, LTD
• Carolina Montoya
• Justin Anthony Moore
• Kelsey Lynn Mora, CCLS, LCPC
• Camilo Morales Hormiga

• Internal Medicine Physician in Northfield, IL
• Providers in Northfield, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.