Active NPI
Samuel T Baz, MD
- Family Medicine Physician
- Wenona, IL
National Provider Identifier
1689624470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Practice address
- 516 S Chestnut St
Wenona, IL 61377-0250 - Phone
- (815) 853-4402
- Fax
- (815) 853-4200
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Primary | |
| Surgery Physician | 208600000X | IL |
Addresses
Primary practice location
516 S Chestnut St
Wenona, IL 61377-0250
Mailing address
516 S Chestnut St
PO Box 250
Wenona, IL 61377-0250
Phone (815) 853-4402
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0006200024 | Other | IL | BLUE CROSS/BLUE SHIELD |
| 017560 | Other | IL | HEALTH ALLIANCE |
| 4581199 | Other | IL | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036049392 | IL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wenona Health Center S C | Family Medicine | Current | 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 and National Provider Directory roles.
-
- Family Medicine Physician
- Wenona, IL
- NPI 1760602254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1689624470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 S CHESTNUT ST",
"address_2": "PO BOX 250",
"city": "WENONA",
"state": "IL",
"postal_code": "613770250",
"telephone_number": "815-853-4402",
"fax_number": "815-853-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 S CHESTNUT ST",
"city": "WENONA",
"state": "IL",
"postal_code": "613770250",
"telephone_number": "815-853-4402",
"fax_number": "815-853-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAZ",
"first_name": "SAMUEL",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": null,
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "0006200024",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "017560",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4581199",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wenona, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.