Scott Smithgall, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036-105701 Issued in IL

Practice address

350 N Wall St
Kankakee, IL 60901-2901

Phone

(815) 933-1671

NPI assigned

Jun 5, 2006

Last updated

Dec 20, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Emergency Medicine

Education

University of New England, College of Osteo Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Emergency Medicine Specialists LLCGroup PAC ID 6103071808, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uchicago Medicine Adventhealth Bolingbrook Hospital, Bolingbrook, IL, CCN 140304

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Illinois Emergency Medicine Specialists, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bolingbrook, IL
  • NPI 1003150962
  Medicare reassignment Care Compare group NPD
• Riverside Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Kankakee, IL
  • NPI 1548969181
  Medicare reassignment NPD
• Emergency Medical Associates of Palos, LTD.

  • Emergency Medicine Physician
  • Palos Heights, IL
  • NPI 1285918128
  NPD (past)
• Palos Emergency Medical Services, LTD

  • Emergency Medicine Physician
  • Palos Heights, IL
  • NPI 1811997885
  NPD (past)
• Suburban Emergency Physicians Group, SC

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1245210038
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Bolingbrook Hospital

  dba Adventhealth Bolingbrook

  • General Acute Care Hospital
  • Bolingbrook, IL
  • NPI 1164530465
  Care Compare affiliation

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1902845027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GREEN RD",
            "address_2": "SUITE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051598",
            "telephone_number": "734-995-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012901",
            "telephone_number": "815-933-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITHGALL",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-105701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105701-1",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssmithgall@rhc.net",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "350 N Wall St",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609012901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joel N Slutsky, MD
• Smart Port Care LLC
• Kenna J Smicker, COTA/L
• Eva Danielle Smith, LCPC
• Margo Smith
• Sophron Counseling Services, PLLC
• Peter D Sotiropoulos, AU.D.
• Sound Physicians of Kankakee Illinois, LLC (Sound Physicians)
• Keon Emmanual Speed
• Taylor Speed, SLP

• Emergency Medicine Physician in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.