Scott R. Samlan, M.D.
Individual provider Active NPI Emergency Medicine Physician · Greenville, IL
NPI 1477575306 · NPPES record last updated May 10, 2019
Key facts
- NPI
- 1477575306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 036114902 (IL)
- Practice address
- 200 Health Care Dr
Greenville, IL 62246-1154 - Phone
- (618) 664-1230
- NPI assigned
- Jul 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01066568A | IN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America Illinois LLP | Emergency Medicine | Current |
Accepting new patients |
| Cep America LLC | Emergency Medicine | Current |
Accepting new patients |
| Cepamerica Illinois LLP | Emergency Medicine | Current |
Accepting new patients |
| Vituity - Illinois Auc LLP | Emergency Medicine | Current |
Accepting new patients |
| Vituity - Illinois Auc LLP | Emergency Medicine | Current |
Accepting new patients |
| Cepamerica Illinois LLP | Emergency Medicine | Current | Accepting new patients |
| Cep America LLC | 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) 851-7423
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 01066568A | IN | |
| Emergency Medicine Physician | 207P00000X | 036114902 | IL | Yes |
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
Other providers in Greenville, IL
- Lance Sterling Rahden
- Nicholas D Rathert
- Rosenburg Chiropractic, LLC
- Raymond J Ryan Jr.
- Zachary D Rynerson
- Jacob Benjamin Sanning
- Sarah Bush Lincoln Health Center
- Anne Elizabeth Schomaker
- Michael David Schultheis
- Veronica Beth Schuster
All providers in Greenville, IL · Emergency Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.