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NPI Code Detail

MEDICARE: SAMANTHA SKLAR D.P.M.

MEDICARE: SAMANTHA SKLAR D.P.M.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramS46078186928IL

General Provider Information

NPI Number : 1619238144
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA SKLAR D.P.M.
Provider Business Mailing Address
First Line : 24 CLARINGTON WAY
Second Line :
City : NORTH BARRINGTON
State : IL
Zip : 60010-6932
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1226 W TAYLOR ST
Second Line :
City : CHICAGO
State : IL
Zip : 60607-4709
Country : US
Telephone Number : 312-243-3769
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2012
Last Update Date : 05/31/2012

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