Individual provider Active NPI

Samuel R. Katz, M.D.

  • Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
  • Glenview, IL
National Provider Identifier
1689627226
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianTaxonomy code 207VH0002X
License
036-061925 Issued in IL
Practice address
2050 Claire CT
Glenview, IL 60025-7635
Phone
(847) 467-7423
Fax
(847) 556-1715
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician 207VH0002X 036-061925 IL Primary

Addresses

Primary practice location

2050 Claire CT
Glenview, IL 60025-7635

Mailing address

2050 Claire CT
Glenview, IL 60025-7635
Phone (847) 467-7423

Other identifiers 2

IdentifierTypeStateIssuer
10650182OtherILCAQH
036061925MedicaidIL

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
I20051122000045 IL Practitioner - Obstetrics/GynecologyPractitioner - Emergency MedicinePractitioner - Hospice/Palliative Care 5294754024 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-061925ILMDHospice and Palliative Medicine (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Journeycare, Inc. CurrentSince Jun 1, 2015 Accepting new patients
Journeycare, Inc CurrentSince Jun 1, 2015 Accepting new patients
Illinois/Indiana Em-I Medical Services, S.C. Past Accepting new patients

Locations

2050 Claire Ct
Glenview, IL 60025
Phone (847) 467-7425

405 Lake Zurich Rd
North Barrington, IL 60010
Phone (847) 381-5599

Organizations & group practices 3

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1689627226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 CLAIRE CT",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257635",
            "telephone_number": "847-467-7423",
            "fax_number": "847-556-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 CLAIRE CT",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257635",
            "telephone_number": "847-467-7423",
            "fax_number": "847-556-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "SAMUEL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VH0002X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": "IL",
            "license": "036-061925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10650182",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061925",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.