Individual provider Active NPI

Waleed Salah Samara, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Romeoville, IL
National Provider Identifier
1710845029
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
637 N Independence Blvd
Romeoville, IL 60446-1342
Phone
(708) 620-4111
NPI assigned
Jan 14, 2026
Last updated
Feb 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IL Primary

Addresses

Primary practice location

637 N Independence Blvd
Romeoville, IL 60446-1342

Mailing address

637 N Independence Blvd
Romeoville, IL 60446-1342

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260330000072 IL Practitioner - Physician Assistant 7719462605 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Physicians Associates, S. C.Group PAC ID 2466672001, 5 clinicians

Practice addresses (Care Compare)

6300 159TH St
Suite C
Oak Forest, IL 60452-2779
Phone (708) 535-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Romeoville Urgent Care PLLC CurrentSince Mar 1, 2026 Accepting new patients

Locations

637 N Independence Blvd
Romeoville, IL 60446
Phone (708) 620-4111

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": "1768348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1710845029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 N INDEPENDENCE BLVD",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 N INDEPENDENCE BLVD",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604461342",
            "telephone_number": "708-620-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARA",
        "first_name": "WALEED",
        "middle_name": "SALAH",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-14",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Romeoville, IL

Sources for this page

Verify at the official NPI Registry.