Samson Monachen, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.035524 Issued in IL

Practice address

2964 Commerce Dr
Johnsburg, IL 60051-5409

Phone

(815) 363-0103

NPI assigned

Sep 20, 2024

Last updated

Sep 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1982421053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 N BURNING BUSH LN",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600561612",
            "telephone_number": "224-261-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2964 COMMERCE DR",
            "city": "JOHNSBURG",
            "state": "IL",
            "postal_code": "600515409",
            "telephone_number": "815-363-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONACHEN",
        "first_name": "SAMSON",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.035524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conrad Walter Mazeski, DDS
• Corinne Anne McCormick, PHARMD
• Trevor Lamont McDonald, DDS
• Carol McGinnis
• Estelle Michelle Milrud, DMD
• Kathy Ha Nguyen
• Eric Owen Nicholls, OD
• Harsimar Nijjar
• Rebecca Nikolai
• Northern Light Care, Inc (Johnsburg Chiropractic and Wellness Center)

• General Practice Dentistry in Johnsburg, IL
• Providers in Johnsburg, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.