Individual provider Active NPI

Scott R. Samlan, M.D.

  • Emergency Medicine Physician
  • Greenville, IL
National Provider Identifier
1477575306
Registry record updated May 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036114902 Issued in IL
Practice address
200 Health Care Dr
Greenville, IL 62246-1154
Phone
(618) 664-1230
NPI assigned
Jul 23, 2006
Last updated
May 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01066568A IN
Emergency Medicine Physician 207P00000X 036114902 IL Primary

Addresses

Primary practice location

200 Health Care Dr
Greenville, IL 62246-1154

Mailing address

4217 Terri Lyn Lane
Northbrook, IL 60062
Phone (312) 404-9945

Other practice location 1

5645 W Addison St
Our Lady of the Resurrection Hospital
Chicago, IL 60634-4403
Phone (773) 282-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061030000545 IL Practitioner - Emergency Medicine 5991702201 Reassigns benefits to 2 organizations
I20090707000719 IN Practitioner - Emergency Medicine 5991702201 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036114902ILMDEmergency Medicine Physician
01066568AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America Illinois LLP Emergency Medicine CurrentSince Jul 10, 2012 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Mar 1, 2019 Accepting new patients
Vituity - Illinois Auc LLP Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
Vituity - Illinois Auc LLP Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Mar 1, 2019 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jul 10, 2012 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

801 W Temple Ave
Effingham, IL 62401
Phone (217) 342-5800

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808

12866 Troxler Ave
Highland, IL 62249
Phone (618) 651-2600

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

801 S Main St
Clinton, IN 47842
Phone (765) 832-1212

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 7

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1477575306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 TERRI LYN LANE",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60062",
            "telephone_number": "312-404-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEALTH CARE DR",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622461154",
            "telephone_number": "618-664-1230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5645 W Addison St",
            "address_2": "Our Lady of the Resurrection Hospital",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606344403",
            "country_code": "US",
            "telephone_number": "773-282-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMLAN",
        "first_name": "SCOTT",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01066568A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036114902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, IL

Sources for this page

Verify at the official NPI Registry.