Active NPI
Loyola University Chicago Wellness Center
- Primary Care Nurse Practitioner
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- Legal business name
- LOYOLA UNIVERSITY CHICAGO WELLNESS CENTER
- Practice address
- 6439 N Sheridan Rd
Chicago, IL 60626-5364 - Phone
- (773) 508-2530
- NPI assigned
- Apr 14, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lanay Samuelson, APRN
- Title
- Associate Director
- Phone
- (312) 915-6374
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | |||
| School Social Worker | 1041S0200X | |||
| Registered Dietitian | 133V00000X | |||
| Registered Nurse | 163W00000X | |||
| Health Educator | 174H00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Gynecology Physician | 207VG0400X | |||
| Psychiatry Physician | 2084P0800X | |||
| Primary Care Nurse Practitioner | 363LP2300X | Primary |
Addresses
Primary practice location
6439 N Sheridan Rd
Chicago, IL 60626-5364
Mailing address
6439 N Sheridan Rd
Chicago, IL 60626-5364
Other names 1
- Loyola University of Chicago
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0961574 | Loyola University Wellness Center | Provider-performed microscopy | Jun 9, 2027 |
National Provider Directory
National Provider DirectoryLocations
6439 N Sheridan Rd
Chicago, IL 60626
Phone (773) 508-2530
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Chicago, IL
- NPI 1225390479
-
- Family Nurse Practitioner
- Chicago, IL
- NPI 1790374973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618358400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1755043200000",
"number": "1659951481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6439 N SHERIDAN RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606265364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6439 N SHERIDAN RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606265364",
"telephone_number": "773-508-2530"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LOYOLA UNIVERSITY CHICAGO WELLNESS CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-14",
"last_updated": "2025-08-13",
"certification_date": "2025-08-13",
"status": "A",
"authorized_official_last_name": "SAMUELSON",
"authorized_official_first_name": "LANAY",
"authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
"authorized_official_telephone_number": "312-915-6374",
"authorized_official_credential": "APRN"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, School",
"state": null,
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse",
"state": null,
"license": null,
"primary": false
},
{
"code": "174H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207VG0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Loyola University of Chicago",
"code": "5",
"type": "Other Name"
}
]
}
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 Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.