MEDICARE: SAMANTHA LOUISE NAU

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
1	103TC0700X	Clinical Psychologist	071.022594	IL

General Provider Information

NPI Number	:	1831040989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA LOUISE NAU

Provider Business Mailing Address
First Line	:	4411 N RAVENSWOOD AVE STE 250
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5802
Country	:	US
Telephone Number	:	773-892-1933
Fax Number	:	773-869-5385

Provider Business Practice Location Address
First Line	:	4411 N RAVENSWOOD AVE STE 250
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5802
Country	:	US
Telephone Number	:	773-892-1933
Fax Number	:	773-869-5385

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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