Healthcare Provider Details

I. General information

NPI: 1346195633
Provider Name (Legal Business Name): SAMANTHA CHIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1554 E ALGONQUIN RD
ALGONQUIN IL
60102-4519
US

IV. Provider business mailing address

1554 E ALGONQUIN RD
ALGONQUIN IL
60102-4519
US

V. Phone/Fax

Practice location:
  • Phone: 224-592-1221
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2694195
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: