Samantha Nicole Vanderslice, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

036-176914 Issued in IL

Practice address

1645 W Jackson Blvd Ste 603
Chicago, IL 60612-2643

Phone

(312) 942-0819

NPI assigned

Mar 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Psychiatry

Education

University of Texas Medical School at Houston, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  Medicare reassignment Care Compare group NPD
• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573

  Psychiatry

  Medicare reassignment Care Compare group NPD
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Medicare reassignment NPD

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1184128647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 603",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122643",
            "telephone_number": "312-942-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 603",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122643",
            "telephone_number": "312-942-0819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-726-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERSLICE",
        "first_name": "SAMANTHA",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036-176914",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-176914",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Vanderlaan, MD, PHD
• Brett Vanderlinden, RN
• Sarah Nicole Vandermolen, APRN, CNP
• Deanne Vanderpoel, FNP
• Allison J Vanderschrag
• Nicole L Vandervoort, M.A. CCC
• David J Vanderweele, M.D.
• Grace Marie Vanderweide-Serrano
• Stefan Vanderweil, M.D.
• Tracy H. Vanderwiel, C.R.N.A.

• Child & Adolescent Psychiatry Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Child & Adolescent Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.