Individual provider Active NPI

Elisa Scott, M.D.

  • Adolescent Medicine (Internal Medicine) Physician
  • Oak Brook, IL
National Provider Identifier
1912949181
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
036-100748 Issued in IL
Practice address
900 Jorie Blvd
Suite 186
Oak Brook, IL 60523-2213
Phone
(630) 954-6700
Fax
(630) 954-1555
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 036-100748 IL Primary

Addresses

Primary practice location

900 Jorie Blvd
Suite 186
Oak Brook, IL 60523-2213

Mailing address

900 Jorie Blvd
Suite 186
Oak Brook, IL 60523-2213
Phone (630) 954-6700

Other identifiers 1

IdentifierTypeStateIssuer
036-100748MedicaidIL

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
I20160506000837 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5991004376

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-100748ILMDAdolescent Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Neoped Associates LTD PastSince Jun 28, 2009 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1912949181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 JORIE BLVD",
            "address_2": "SUITE 186",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232213",
            "telephone_number": "630-954-6700",
            "fax_number": "630-954-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 JORIE BLVD",
            "address_2": "SUITE 186",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232213",
            "telephone_number": "630-954-6700",
            "fax_number": "630-954-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "ELISA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "IL",
            "license": "036-100748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-100748",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

Verify at the official NPI Registry.