Healthcare Provider Details

I. General information

NPI: 1629993696
Provider Name (Legal Business Name): STAMATIA SAMANTHA ROBBINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 W ARMITAGE AVE
CHICAGO IL
60614-4372
US

IV. Provider business mailing address

644 N TAYLOR AVE
OAK PARK IL
60302-1748
US

V. Phone/Fax

Practice location:
  • Phone: 312-420-9599
  • Fax: 312-420-9599
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180018609
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: