Individual provider Active NPI

Lawrence J Schouten, MD

  • Internal Medicine Physician
  • Carol Stream, IL
National Provider Identifier
1699770164
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036066066 Issued in IL
Practice address
501 Thornhill Dr # DDR
Carol Stream, IL 60188
Phone
(630) 668-3210
Fax
(630) 668-3505
NPI assigned
Jun 20, 2005
Last updated
Sep 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036066066 IL Primary

Addresses

Primary practice location

501 Thornhill Dr # DDR
Carol Stream, IL 60188

Mailing address

501 Thornhill Dr
Carol Stream, IL 60188-2793
Phone (630) 668-3210

Other practice location 1

290 Springfield Dr
Suite 290
Bloomingdale, IL 60108-2214
Phone (630) 893-9660

Other identifiers 3

IdentifierTypeStateIssuer
F400172434OtherILMEDICARE PTAN (INDIVIDUAL)
920540OtherILMEDICARE PTAN (GROUP)
036066066MedicaidIL

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

LicenseStateTypeSpecialty
036066066ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stratford Internal Medicine, SC Internal Medicine PastSince Aug 1, 2005 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, 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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1699770164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 THORNHILL DR",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882793",
            "telephone_number": "630-668-3210",
            "fax_number": "630-668-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 THORNHILL DR # DDR",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "60188",
            "telephone_number": "630-668-3210",
            "fax_number": "630-668-3505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 Springfield Dr",
            "address_2": "Suite 290",
            "address_purpose": "LOCATION",
            "city": "Bloomingdale",
            "state": "IL",
            "postal_code": "601082214",
            "country_code": "US",
            "telephone_number": "630-893-9660",
            "fax_number": "630-893-9668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHOUTEN",
        "first_name": "LAWRENCE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036066066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "F400172434",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "920540",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036066066",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carol Stream, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.