Samantha Carrie Israel, A.P.N

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.014110 Issued in IL

Practice address

5841 S Maryland Ave
MC# 4028
Chicago, IL 60637-1447

Phone

(773) 702-1000

NPI assigned

Mar 29, 2016

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 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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1457714479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR",
            "address_2": "SUITE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605277594",
            "telephone_number": "773-702-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "address_2": "MC# 4028",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISRAEL",
        "first_name": "SAMANTHA",
        "middle_name": "CARRIE",
        "name_prefix": "Ms.",
        "credential": "A.P.N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.380310",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.014110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ismile Dental LLC
• Atinuke C Isola, CLC
• Israel J Warens DDS PC
• Amanda Israel, MD
• Marni Israel
• Shemuel B Israel, D.C.
• Nabil Mohamed Issa, MD
• Naoum Issa
• Ola M Issa, PHARMD
• Ramzy Peter Issa

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.