Individual provider Active NPI

Samantha Kornhauser, APN-CNP

  • Nurse Practitioner
  • Glenview, IL
National Provider Identifier
1255941928
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209019888 Issued in IL
Practice address
2150 Pfingsten Rd Ste 3000
Glenview, IL 60026-1314
Phone
(847) 657-1700
Fax
(847) 657-1715
NPI assigned
Aug 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 209.019888 IL
Nurse Practitioner 363L00000X 209019888 IL Primary

Addresses

Primary practice location

2150 Pfingsten Rd Ste 3000
Glenview, IL 60026-1314

Mailing address

2150 Pfingsten Rd Ste 3000
Glenview, IL 60026-1314
Phone (847) 657-1700

Other practice location 1

2400 N Ashland Ave
Chicago, IL 60614-2021
Phone (773) 270-5600

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210120000558 IL Practitioner - Nurse Practitioner 4284047960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Suite 2218a
Evanston, IL 60201-1700
Phone (847) 503-4222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.019888ILMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jan 1, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Jan 1, 2021 Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

9532 Eagle Way
Chicago, IL 60678

1000 Central St
Ste 800
Evanston, IL 60201
Phone (847) 570-2503

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2150 Pfingsten Rd
Ste 3000
Glenview, IL 60026
Phone (847) 657-1700

757 Park Ave W
Ste 2850
Highland Park, IL 60035
Phone (847) 570-2512

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1255941928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 PFINGSTEN RD STE 3000",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261314",
            "telephone_number": "847-657-1700",
            "fax_number": "847-657-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 PFINGSTEN RD STE 3000",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261314",
            "telephone_number": "847-657-1700",
            "fax_number": "847-657-1715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 N Ashland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606142021",
            "country_code": "US",
            "telephone_number": "773-270-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORNHAUSER",
        "first_name": "SAMANTHA",
        "credential": "APN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209.019888",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209019888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.