Samuel Assam, P

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209024296 Issued in IL

Practice address

213 N Morgan St Unit 1D
Chicago, IL 60607-1721

Phone

(312) 888-2986

NPI assigned

Jun 6, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Paragon Clinical LLCGroup PAC ID 7214034925, 15 clinicians

Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.samuelassam@146897.advancedmd-direct.com

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.

• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  IL, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Paragon Clinical LLC

  • Nurse Practitioner
  • Burr Ridge, IL
  • NPI 1114139946

  IL, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Paragon Clinical Midwest, LLC

  • Nurse Practitioner
  • Merrillville, IN
  • NPI 1619335700

  IL

  Medicare reassignment NPD
• MD Medical, LLC

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1467754911
  NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  NPD (past)
• Psychology Specialists LTD

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1881323905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "486 W BOUGHTON RD # B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402399",
            "telephone_number": "630-566-2090",
            "fax_number": "833-646-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N MORGAN ST UNIT 1D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071721",
            "telephone_number": "312-888-2986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 N Irving Park Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60607",
            "country_code": "US",
            "telephone_number": "312-888-2986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASSAM",
        "first_name": "SAMUEL",
        "credential": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-06",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209024296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2021033717",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenny Aspurez, RN
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• Alexandra Isa Asrow, M.D.
• Farahnak Assadi, M.D.
• Georges Assaf, M.D.
• William Okuaben Assan, MPH
• Aryanah Assar
• Emily Assef, MSW
• Ibrahim Asseidat, M.D.
• Assiste Home Care Services Corp.

• All providers in Chicago, IL
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.