Healthcare Provider Details

I. General information

NPI: 1245143528
Provider Name (Legal Business Name): SAMANTHA LEIGH FOX P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 N ORCHARD ST APT 404
CHICAGO IL
60657-6698
US

IV. Provider business mailing address

2860 N ORCHARD ST APT 404
CHICAGO IL
60657-6698
US

V. Phone/Fax

Practice location:
  • Phone: 847-681-3988
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA LEIGH FOX
Title or Position: PRESIDENT/OWNER
Credential: PSYD
Phone: 847-681-3988