Individual provider Active NPI

Denise Catherine Sample, MSN, APN, FNP-BC

  • Nurse Practitioner
  • McHenry, IL
National Provider Identifier
1801723804
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.035555 Issued in IL
Practice address
4305 W Medical Center Dr Ste 1
McHenry, IL 60050-8425
Phone
(847) 535-7058
Fax
(847) 535-7023
NPI assigned
May 5, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.276148 IL
Nurse Practitioner 363L00000X 209.035555 IL Primary

Addresses

Primary practice location

4305 W Medical Center Dr Ste 1
McHenry, IL 60050-8425

Mailing address

4305 W Medical Center Dr Ste 1
McHenry, IL 60050-8425
Phone (847) 535-7058

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4305 W Medical Ctr Dr
Suite 1
McHenry, IL 60050-8425

5777 Dept
Carol Stream, IL 60122-0021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
041.276148ILMDRegistered Nurse
209.035555ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1777939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1801723804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 W MEDICAL CENTER DR STE 1",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508425",
            "telephone_number": "847-535-7058",
            "fax_number": "847-535-7023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 W MEDICAL CENTER DR STE 1",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508425",
            "telephone_number": "847-535-7058",
            "fax_number": "847-535-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLE",
        "first_name": "DENISE",
        "middle_name": "CATHERINE",
        "credential": "MSN, APN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-05",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.276148",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.035555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.