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NPI Code Detail

MEDICARE: DR. SCOTT GLEN ASSELMEIER M.D.

MEDICARE: DR. SCOTT GLEN ASSELMEIER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0204XVascular & Interventional Radiology Physician036-115765IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558563213
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT GLEN ASSELMEIER M.D.
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 450 W HIGHWAY 22
Second Line : DEPT OF RADIOLOGY
City : BARRINGTON
State : IL
Zip : 60010-1919
Country : US
Telephone Number : 312-563-4270
Fax Number : 312-563-4280
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2007
Last Update Date : 03/04/2026

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