Individual provider Active NPI

Timothy Schroer, D.O.

  • Emergency Medicine Physician
  • Chicago Heights, IL
National Provider Identifier
1861433138
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-112038 Issued in IL
Practice address
1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone
(708) 756-1000
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 02003312A IN
Emergency Medicine Physician 207P00000X 036-112038 IL Primary

Addresses

Primary practice location

1423 Chicago Rd
Chicago Heights, IL 60411-3400

Mailing address

555 W Court St
Kankakee, IL 60901-3675
Phone (888) 828-3192

Other identifiers 3

IdentifierTypeStateIssuer
036112038MedicaidIL
0097714MedicaidOH
4622394OtherBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100611000555 IN Practitioner - Emergency MedicinePractitioner - Osteopathic Manipulative Medicine 6901869700 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-112038ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Indiana, P.C. Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Foundation for Emergency Services Emergency Medicine Past Accepting new patients
Emergency Care & Health Organization, LTD Emergency Medicine Past Accepting new patients
Emergency Medicine of Indiana Emergency Medicine Past Accepting new patients
Innovative Hospital Care, LLC Past Accepting new patients
Emergency Care & Heallth Organization, LTD Emergency Medicine Past Accepting new patients

Locations

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

702 Van Buren St
Fort Wayne, IN 46802
Phone (260) 425-3000

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

2101 Dubois Dr
Warsaw, IN 46580
Phone (219) 267-3200

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1861433138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013675",
            "telephone_number": "888-828-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 CHICAGO RD",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113400",
            "telephone_number": "708-756-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROER",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02003312A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-112038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112038",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097714",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4622394",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

Verify at the official NPI Registry.