Samantha B. Conrad M.D.S.C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036107758 Issued in IL

Legal business name

SAMANTHA B. CONRAD M.D.S.C

Practice address

360 W Butterfield Rd
Suite 240
Elmhurst, IL 60126-5068

Phone

(847) 590-1500

Fax

(847) 590-1500

NPI assigned

Jul 9, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Samantha B Conrad, M.D.NPI 1134150360

Title

Owner

Phone

(847) 590-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samantha B Conrad, MD

  • Dermatology Physician
  • Chicago, IL
  • NPI 1134150360
  NPD Authorized official
• David Scott Pezen, M.D.

  • Dermatology Physician
  • Elmhurst, IL
  • NPI 1801881313
  NPD

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345680000000",
    "number": "1821353673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 N ARLINGTON HEIGHTS RD",
            "address_2": "203E",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600043982",
            "telephone_number": "847-590-1500",
            "fax_number": "847-590-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD",
            "address_2": "SUITE 240",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265068",
            "telephone_number": "847-590-1500",
            "fax_number": "847-590-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMANTHA B. CONRAD M.D.S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-09",
        "last_updated": "2012-08-23",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-590-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036107758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107758",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Kathleen Salata, MSN, FNP-BC
• Ashley Saleem, DO
• Guadalupe R Salgado
• Cedric Salone, PHARM.D
• Nooshig Luz Salvador, M.D.
• Armando A San Juan, MD
• Heather Ann San Juan, APN
• Rodolfo Javier San Juan III, MD
• Andrea San Luis, PT
• Prateek Sanan

• Dermatology Physician in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2012; 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.