Individual provider Active NPI

Samantha Bugno, DNP, CPNP-PC

  • Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1871395665
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209.031024 Issued in IL
Practice address
211 E Grand Ave
Chicago, IL 60611-3311
Phone
(312) 229-0170
Fax
(312) 600-9072
NPI assigned
Mar 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209.031024 IL Primary

Addresses

Primary practice location

211 E Grand Ave
Chicago, IL 60611-3311

Mailing address

211 E Grand Ave
Chicago, IL 60611-3311
Phone (312) 229-0170

Other practice location 1

7S721 Route 53
Naperville, IL 60540-9528
Phone (630) 271-9155

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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
209.031024ILMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1871395665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113311",
            "telephone_number": "312-229-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113311",
            "telephone_number": "312-229-0170",
            "fax_number": "312-600-9072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7S721 Route 53",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605409528",
            "country_code": "US",
            "telephone_number": "630-271-9155",
            "fax_number": "630-271-9186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUGNO",
        "first_name": "SAMANTHA",
        "credential": "DNP, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209.031024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.