Shirly Susan Samuel, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036.165713 Issued in IL

Practice address

101 Madison St Ste 300
Oak Park, IL 60302-4210

Phone

(708) 486-2700

Fax

(708) 847-2702

NPI assigned

Apr 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cimpar SCGroup PAC ID 3577578798, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loretto Hospital Hospital, Chicago, IL, CCN 140083
• Citadel at Casa Scalabrini Nursing home, Northlake, IL, CCN 145956

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cimpar, S.C.

  • Internal Medicine Physician
  • Oak Park, IL
  • NPI 1467496224
  Medicare reassignment Care Compare group NPD
• Loretto Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1447280284
  NPD (past)

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

• Citadel at Casa Scalabrini LLC

  • Skilled Nursing Facility
  • Northlake, IL
  • NPI 1023859048

  Nursing home

  Care Compare affiliation
• Loretto Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1447280284
  Care Compare affiliation

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1619506508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MADISON ST STE 300",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603024210",
            "telephone_number": "708-486-2700",
            "fax_number": "708-847-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MADISON ST STE 300",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603024210",
            "telephone_number": "708-486-2700",
            "fax_number": "708-847-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "SHIRLY",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2023-07-24",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.165713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree Salgado
• Caroline J Salozzo, RDN
• Leah B. Samler, PSY.D.
• Elizabeth Ann Samore, D.D.S.
• Francis Sampey, MS,CCC-SLP
• Megan Rose Samuelson, MSOT, OTR/L
• Claudette L Sanchez, M.A., CCC-SLP
• Javier Sanchez
• Tamra L Sanders, MSN, BSN, RN
• Marc Sandrolini, M.D.

• Internal Medicine Physician in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.