Minette Roque Sampang, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209029652 Issued in IL

Practice address

1106 Neal Ave
Joliet, IL 60433-2548

Phone

(815) 727-8670

NPI assigned

May 17, 2024

Last updated

Dec 16, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: minette.sampang.p25@direct.willcounty.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Will County Community Health Center

  dba Will County Community Health Center East

  • Federally Qualified Health Center (FQHC)
  • Monee, IL
  • NPI 1053870204
  NPD (past)

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1912756339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 NEAL AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604332548",
            "telephone_number": "815-727-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 NEAL AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604332548",
            "telephone_number": "815-727-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPANG",
        "first_name": "MINETTE",
        "middle_name": "ROQUE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209029652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Sallade, COTA
• James Greggory Salvatore, D.C.
• Salwa F Asaad (Joliet Radiation Oncology)
• Sam's Club Optical (Sam's Club Optical 30-8298)
• Danna Samara, PHARMD
• Chintan Sampat, M.D.
• Ramesh D. Sampat, D.D.S.
• Sams West Inc (Sams Pharmacy)
• Reny A Samuel, PT
• Dianne Sanchez, PT

• Psychiatric/Mental Health Nurse Practitioner in Joliet, IL
• Providers in Joliet, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.