Individual provider Active NPI

Samantha Garofalo

  • Family Nurse Practitioner
  • Wheaton, IL
National Provider Identifier
1689595936
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.035984 Issued in IL
Practice address
810 Pershing Ave
Wheaton, IL 60189-6585
Phone
(630) 808-3031
NPI assigned
Jul 23, 2026
Last updated
Jul 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.035984 IL Primary

Addresses

Primary practice location

810 Pershing Ave
Wheaton, IL 60189-6585

Mailing address

810 Pershing Ave
Wheaton, IL 60189-6585
Phone (630) 808-3031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1784764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1689595936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 PERSHING AVE",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601896585",
            "telephone_number": "630-808-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 PERSHING AVE",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601896585",
            "telephone_number": "630-808-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAROFALO",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.035984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.