Individual provider Active NPI

Samantha Robin Schulze, PSY.D.

  • Clinical Psychologist
  • Arlington Heights, IL
National Provider Identifier
1023263308
Registry record updated Nov 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.006254 Issued in IL
Practice address
3800 N Wilke Rd
Suite 160
Arlington Heights, IL 60004-1278
Phone
(847) 577-0881
NPI assigned
Nov 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.006254 IL Primary

Addresses

Primary practice location

3800 N Wilke Rd
Suite 160
Arlington Heights, IL 60004-1278

Mailing address

656 Hyacinth PL
Highland Park, IL 60035-1170
Phone (847) 780-4104

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140822002362 IL Practitioner - Clinical Psychologist 9436307253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2201 Lakeside Dr
Bannockburn, IL 60015-1265
Phone (773) 909-9614

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.006254ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Peaceful Mind Therapy, PLLC CurrentSince Apr 12, 2021 Accepting new patients

Locations

2201 Lakeside Dr
Bannockburn, IL 60015
Phone (312) 547-1931

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": "1228003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228003200000",
    "number": "1023263308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 HYACINTH PL",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600351170",
            "telephone_number": "847-780-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N WILKE RD",
            "address_2": "SUITE 160",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041278",
            "telephone_number": "847-577-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULZE",
        "first_name": "SAMANTHA",
        "middle_name": "ROBIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-30",
        "last_updated": "2008-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.006254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.