DR. SAMUEL T BAZ (NPI# 1689624470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689624470 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL T BAZ |
| Credential | MD |
| Practice Address |
516 S Chestnut St Wenona IL 61377-0250 |
| Mailing Address |
516 S Chestnut St Po Box 250 Wenona IL 61377-0250 |
| Practice Telephone | 8158534402 |
| Practice Fax Number | 8158534200 |
| Mailing Telephone | 8158534402 |
| Mailing Fax Number | 8158534200 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207Q00000X | Family Medicine | IL | Allopathic & Osteopathic Physicians | |
| X | 208600000X | Surgery | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | AETNA | 4581199 | 01 |
| IL | HEALTH ALLIANCE | 017560 | 01 |
| IL | BLUE CROSS/BLUE SHIELD | 0006200024 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720196256 | Samuel Baz | Internal Medicine | 11201 Benton St, 111h, Loma Linda, CA 92357-1000 | 2006-08-25 |
| Street Address |
516 S CHESTNUT ST |
| City | WENONA |
| State | IL |
| Zip Code | 61377-0250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770533648 | Bella Y Baz | Pediatrics | 516 S Chestnut St, Wenona, IL 61377-0250 | 2006-05-11 |
| 1316358187 | Hshs Medical Group Inc | Clinic/Center | 516 S Chestnut St, Wenona, IL 61377-7526 | 2014-05-15 |
| 1699066084 | Jawaria T Suhail | Family Medicine | 516 S Chestnut St, Wenona, IL 61377-7526 | 2011-04-20 |
| 1386671709 | Angela Martinez | Family Medicine | 516 S Chestnut St, Wenona, IL 61377-7526 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760602254 | Wenona Health Center S C | Pediatrics | 516 S. Chestnut St, Wenona, IL 61377 | 2007-04-26 |
| 1376684738 | Eastern Marshall County Ems | Ambulance | 210 North Chestnut St, Wenona, IL 61377-0708 | 2007-02-09 |
| 1255312823 | Tyner Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 120 N Chestnut St, Wenona, IL 61377-7527 | 2005-11-09 |
| 1144336439 | Sharshon Pharmacy Inc | Pharmacy | 120 N Chestnut St, Wenona, IL 61377-7527 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760602254 | Wenona Health Center S C | Pediatrics | 516 S. Chestnut St, Wenona, IL 61377 | 2007-04-26 |
| 1376684738 | Eastern Marshall County Ems | Ambulance | 210 North Chestnut St, Wenona, IL 61377-0708 | 2007-02-09 |
| 1255312823 | Tyner Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 120 N Chestnut St, Wenona, IL 61377-7527 | 2005-11-09 |
| 1316358187 | Hshs Medical Group Inc | Clinic/Center | 516 S Chestnut St, Wenona, IL 61377-7526 | 2014-05-15 |
| 1699066084 | Jawaria T Suhail | Family Medicine | 516 S Chestnut St, Wenona, IL 61377-7526 | 2011-04-20 |
| 1144336439 | Sharshon Pharmacy Inc | Pharmacy | 120 N Chestnut St, Wenona, IL 61377-7527 | 2006-08-21 |
| 1386671709 | Angela Martinez | Family Medicine | 516 S Chestnut St, Wenona, IL 61377-7526 | 2006-06-28 |
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699066084 | Jawaria T Suhail | Family Medicine | 516 S Chestnut St, Wenona, IL 61377-7526 | 2011-04-20 |
| 1386671709 | Angela Martinez | Family Medicine | 516 S Chestnut St, Wenona, IL 61377-7526 | 2006-06-28 |
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|---|---|---|---|---|
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| 1194330977 | Home Doctors for You | Family Medicine | 670 Illinois Blvd, Hoffman Est, IL 60169-3363 | 2020-09-09 |
| 1245844489 | Jovita Zalwango Nassolo | Family Medicine | 116 1/2 N Benton St Apt 2d, Woodstock, IL 60098-3272 | 2020-09-04 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1417565755 | Ghr Total Health and Consulting | Family Medicine | 11336 Mckenna Dr, Frankfort, IL 60423-8096 | 2020-07-22 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.