Individual provider Active NPI

Scott R. Schieber, M.D.

  • Internal Medicine Physician
  • Orland Park, IL
National Provider Identifier
1417971797
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036067898 Issued in IL
Practice address
16660 S. 107TH Ave.
Orland Park, IL 60467-8898
Phone
(708) 403-8500
Fax
(708) 364-7080
NPI assigned
Jul 27, 2006
Last updated
Aug 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036067898 IL Primary

Addresses

Primary practice location

16660 S. 107TH Ave.
Orland Park, IL 60467-8898

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 5

IdentifierTypeStateIssuer
705600OtherILMEDICARE GROUP #
01630151OtherILBCBS PROVIDER GROUP #
14D0991123OtherILCLIA #
4082647OtherILAETNA PROVIDER ID#
036067898MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sschieber133347@dulyhealthandcare.direct-ci.com

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
I20051014000787 IL Practitioner - Internal Medicine 2264458694 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036067898ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orland Primary Care Specialists Internal Medicine CurrentSince Nov 28, 2005 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1417971797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16660 S. 107TH AVE.",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678898",
            "telephone_number": "708-403-8500",
            "fax_number": "708-364-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIEBER",
        "first_name": "SCOTT",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036067898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "705600",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER GROUP #",
            "identifier": "01630151",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "14D0991123",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID#",
            "identifier": "4082647",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036067898",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sschieber133347@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "16660 S. 107th Ave.",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604678898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.