Individual provider Active NPI

Scott P Ciechna, M.D.

  • Family Medicine Physician
  • Channahon, IL
National Provider Identifier
1508803776
Registry record updated Nov 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36-111123 Issued in IL
Practice address
27240 W Saxony Dr
Suite 201
Channahon, IL 60410-1415
Phone
(815) 467-1518
Fax
(815) 467-7419
NPI assigned
May 31, 2006
Last updated
Nov 20, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36-111123 IL Primary

Addresses

Primary practice location

27240 W Saxony Dr
Suite 201
Channahon, IL 60410-1415

Mailing address

25259 S Reed St
Channahon, IL 60410-6003
Phone (815) 941-9124

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
I20041115000518 IL Practitioner - Family Practice 5698739258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

27240 W Saxony Dr
Suite 201
Channahon, IL 60410-1417
Phone (815) 467-1518

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36-111123ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Hospital Family Medicine Current Accepting new patients
Morris Hospital CurrentSince Jan 1, 2017 Accepting new patients
Morris Hospital CurrentSince Jan 1, 2017 Accepting new patients
Morris Hospital Current Accepting new patients
Presence Service Corporation Family Medicine Past Accepting new patients

Locations

389 E Main St
Braidwood, IL 60408
Phone (815) 458-2532

25259 S Reed St
Channahon, IL 60410
Phone (815) 467-0555

27240 W Saxony Dr
Ste 201
Channahon, IL 60410
Phone (815) 467-1518

580 Sycamore St
Marseilles, IL 61341
Phone (815) 795-2122

150 W High St
Morris, IL 60450
Phone (815) 942-2129

725 School St
Ste A
Morris, IL 60450

Interoperability endpoints

  • Direct secure messaging: scott.ciechna.1@14307.direct.athenahealth.com
  • Direct secure messaging: scott.ciechna@direct-address.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1508803776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25259 S REED ST",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604106003",
            "telephone_number": "815-941-9124",
            "fax_number": "815-941-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27240 W SAXONY DR",
            "address_2": "SUITE 201",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604101415",
            "telephone_number": "815-467-1518",
            "fax_number": "815-467-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIECHNA",
        "first_name": "SCOTT",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36-111123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Channahon, IL

Sources for this page

Verify at the official NPI Registry.