Active NPI
Samuel Logan, APN
- Family Nurse Practitioner
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 277000181
- 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, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 277000181 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promise Healthcare NFP | Current | Accepting new patients | |
| Friend Family Health Center Inc | Current | Accepting new patients | |
| Friend Family Health Center Inc | Current | Accepting new patients | |
| Friend Family Health Center Inc | Current | Accepting new patients | |
| Promise Healthcare NFP | Current | Accepting new patients | |
| Promise Healthcare NFP | Current | 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.
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1578560090
-
dba Frances Nelson Health Center
- Federally Qualified Health Center (FQHC)
- Champaign, IL
- NPI 1578821005
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1457525792
-
dba Friend Health - Gresham
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1477175305
-
dba FN on Neil St.
- Federally Qualified Health Center (FQHC)
- Champaign, IL
- NPI 1043936438
-
dba Promise Healthcare - Ready School
- Federally Qualified Health Center (FQHC)
- Champaign, IL
- NPI 1801687728
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1508956509
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; 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.