Madeline Olivia Sansom

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PRE-LIC

Practice address

1147 W Ohio St Ste 103
Chicago, IL 60642-5874

Phone

(312) 772-9796

NPI assigned

May 23, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Optimum Joy, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1053825380
  NPD

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1689413148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 W OHIO ST UNIT 103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60642",
            "telephone_number": "312-772-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 W OHIO ST STE 103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606425874",
            "telephone_number": "312-772-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSOM",
        "first_name": "MADELINE",
        "middle_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "PRE-LIC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meaghan E Sankot
• Deepti Sanku, MD
• Leslie Karen Sann, L.C.P.C.
• Robert Benson Sanoshy, LCSW
• Alejandria P. Sanpablo, MD
• Sarah Sansom, D.O.
• Victoria Lynn Sansom, MOT
• Marilu Santa Cruz, LCSW
• Brittany Anisse Santa Marina, DNP, CRNA
• Erin Santacrose, RN

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.