Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Scott Alan Southerland, PA

Individual provider Physician Assistant · NPI 1639492804

Mr. Scott Alan Southerland, PA is a Physician Assistant in Winfield, Illinois. Qualified in 2009, 17 years ago. Practices with Northwestern Medical Faculty Foundation, a 4,394-clinician group and accepts Medicare assignment. Licensed in Alabama and Illinois.

Years since qualifying
17
Licensed in
AL, IL
In the registry since
2010
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

25 N Winfield Rd
Winfield, IL 60190-1379
Phone: (630) 232-0280
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085006027 (IL)
Physician Assistant Taxonomy 363A00000X · Licence TA1704 (AL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 695 (AL)

Record details

NPI number1639492804
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 2, 2010
Last updated in NPPESFebruary 15, 2022
Certification dateFebruary 15, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Northwestern Medical Faculty Foundation — 4394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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