Individual provider Active NPI

Alan Summers, MD

  • Neurology Physician
  • Oswego, IL
National Provider Identifier
1417918624
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036082533 Issued in IL
Practice address
80 Templeton Dr
Oswego, IL 60543
Phone
(630) 554-3456
Fax
(630) 551-3970
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036082533 IL Primary

Addresses

Primary practice location

80 Templeton Dr
Oswego, IL 60543

Mailing address

2357 Sequoia Dr
Aurora, IL 60506-6222
Phone (630) 907-3969

Other practice location 1

25 N Winfield Rd
Ste 405
Winfield, IL 60190
Phone (630) 784-7700

Other practice location 2

25 N Winfield Rd
Ste 405
Winfield, IL 60190
Phone (630) 784-7700

Other practice location 3

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Other identifiers 1

IdentifierTypeStateIssuer
036082533MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asummers163276@direct.luhs.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040216000639 IL Practitioner - Neurology 7618862186

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1417918624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2357 SEQUOIA DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605066222",
            "telephone_number": "630-907-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 TEMPLETON DR",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "60543",
            "telephone_number": "630-554-3456",
            "fax_number": "630-551-3970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 N Winfield Rd",
            "address_2": "Ste 405",
            "address_purpose": "LOCATION",
            "city": "Winfield",
            "state": "IL",
            "postal_code": "60190",
            "country_code": "US",
            "telephone_number": "630-784-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 N Winfield Rd",
            "address_2": "Ste 405",
            "address_purpose": "LOCATION",
            "city": "Winfield",
            "state": "IL",
            "postal_code": "60190",
            "country_code": "US",
            "telephone_number": "630-784-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036082533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036082533",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asummers163276@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

Verify at the official NPI Registry.