Individual provider Active NPI

Monica Kristin Samelson, MD

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1003279464
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.163441 Issued in IL
Practice address
1806 W Cuyler Ave Ste 103
Chicago, IL 60613-2541
Phone
(206) 558-5495
NPI assigned
Apr 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD60978381 WA
Psychiatry Physician 2084P0800X 183790 CA
Psychiatry Physician 2084P0800X 036.163441 IL Primary

Addresses

Primary practice location

1806 W Cuyler Ave Ste 103
Chicago, IL 60613-2541

Mailing address

1806 W Cuyler Ave Ste 103
Chicago, IL 60613-2541
Phone (206) 558-5495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 3, 2020 through Aug 3, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60978381WAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1003279464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 W CUYLER AVE STE 103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132541",
            "telephone_number": "206-558-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 W CUYLER AVE STE 103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132541",
            "telephone_number": "206-558-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMELSON",
        "first_name": "MONICA",
        "middle_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-03",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60978381",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "183790",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.163441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.