Samantha K Ipek

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.014979 Issued in IL

Practice address

12 Health Services Dr
Dekalb, IL 60115-9637

Phone

(815) 756-4875

Fax

(815) 756-2944

NPI assigned

Jul 25, 2016

Last updated

Nov 2, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Samantha K Kiourtzidis Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: szeigler160113@direct.dhha.org

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.

• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452
  Medicare reassignment Care Compare group NPD
• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793577600000",
    "number": "1548713704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1109",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601157109",
            "telephone_number": "815-756-4875",
            "fax_number": "815-756-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 HEALTH SERVICES DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159637",
            "telephone_number": "815-756-4875",
            "fax_number": "815-756-2944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1260 H St",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "80631",
            "country_code": "US",
            "telephone_number": "970-400-3894",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1795 Jet Wing Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809162332",
            "country_code": "US",
            "telephone_number": "719-572-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12801 Lafayette St Unit B303",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802411806",
            "country_code": "US",
            "telephone_number": "812-716-0110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IPEK",
        "first_name": "SAMANTHA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2026-11-02",
        "certification_date": "2026-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.014979",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0014870",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "szeigler160113@direct.dhha.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "777 Bannock St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802044597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "KIOURTZIDIS",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.

Verify at the official NPI Registry.