Individual provider Active NPI

Alexis Marie Sampson, PA-C

  • Physician Assistant
  • Niles, IL
National Provider Identifier
1477043057
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006584 Issued in IL
Practice address
6450 W Touhy Ave
Niles, IL 60714-4512
Phone
(773) 631-2223
Fax
(773) 631-5607
NPI assigned
May 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085006584 IL Primary

Addresses

Primary practice location

6450 W Touhy Ave
Niles, IL 60714-4512

Mailing address

2650 Ridge Ave
Evanston, IL 60201-1700
Phone (847) 982-3175

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address asampson@direct.iuhealth.org Direct
Direct Messaging Address asampson@direct.iuhealth.org Direct
Direct Messaging Address asampson@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190326001885 IL Practitioner - Physician Assistant 6305186594 Reassigns benefits to 1 organization
I20241120001901 IN Practitioner - Physician Assistant 6305186594 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

6450 W Touhy Ave
Niles, IL 60714-4512

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc. CurrentSince Dec 1, 2024 Accepting new patients
University Family Physicians, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Aldad Medical PC CurrentSince Aug 1, 2023 Accepting new patients
Aldad Medical PC CurrentSince Aug 1, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Jul 1, 2025 Accepting new patients
TT Medical Group LLC Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

9532 Eagle Way
Chicago, IL 60678

159 N Sangamon St
Ste 200300
Chicago, IL 60607
Phone (872) 246-7320

7216 Solutions Ctr
Chicago, IL 60677

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

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

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

6450 W Touhy Ave
Niles, IL 60714
Phone (847) 583-1000

1111 Ronald Reagan Pkwy
Avon, IN 46123
Phone (317) 217-3000

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

550 University Blvd
#3005
Indianapolis, IN 46202
Phone (317) 944-2167

9650 E Washington St
Ste 100
Indianapolis, IN 46229
Phone (317) 890-5500

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051

Organizations & group practices 9

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 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": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1477043057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-982-3175",
            "fax_number": "847-982-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 W TOUHY AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144512",
            "telephone_number": "773-631-2223",
            "fax_number": "773-631-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPSON",
        "first_name": "ALEXIS",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asampson@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 University Blvd # Uh3005",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asampson@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9650 E Washington St Ste 100",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462293032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asampson@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1111 Ronald Reagan Pkwy",
            "city": "Avon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461237085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

Verify at the official NPI Registry.