Individual provider Active NPI

Samuel Logan, APN

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1386012482
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277000181 Issued in IL
Practice address
3600 W Fullerton Ave
Chicago, IL 60647-2319
Phone
(773) 782-2800
Fax
(773) 782-5042
NPI assigned
Sep 4, 2015
Last updated
Sep 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 277000181 IL Primary

Addresses

Primary practice location

3600 W Fullerton Ave
Chicago, IL 60647-2319

Mailing address

3600 W Fullerton Ave
Chicago, IL 60647-2319
Phone (773) 782-2800

Other practice location 1

6416 W Belmont Ave
Chicago, IL 60634-3921
Phone (773) 782-2800

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
I20150925000715 IL Practitioner - Nurse Practitioner 0941518823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Friend Family Health Center IncGroup PAC ID 2062494552, 36 clinicians

Practice addresses (Care Compare)

6250 S Cottage Grove Ave
Chicago, IL 60637-2530
Phone (773) 702-0660

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
277000181ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promise Healthcare NFP CurrentSince Aug 25, 2015 Accepting new patients
Friend Family Health Center Inc CurrentSince Sep 19, 2021 Accepting new patients
Friend Family Health Center Inc CurrentSince Sep 19, 2021 Accepting new patients
Friend Family Health Center Inc Current Accepting new patients
Promise Healthcare NFP Current Accepting new patients
Promise Healthcare NFP CurrentSince Aug 25, 2015 Accepting new patients

Locations

819 Bloomington Rd
Champaign, IL 61820
Phone (217) 356-1558

1522 E 63rd St
Chicago, IL 60637
Phone (773) 795-2260

800 E 55th St
Chicago, IL 60615
Phone (773) 702-2193

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1386012482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472319",
            "telephone_number": "773-782-2800",
            "fax_number": "773-782-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472319",
            "telephone_number": "773-782-2800",
            "fax_number": "773-782-5042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6416 W Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606343921",
            "country_code": "US",
            "telephone_number": "773-782-2800",
            "fax_number": "773-782-5042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "SAMUEL",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-04",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277000181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.