Healthcare Provider Details

I. General information

NPI: 1891669560
Provider Name (Legal Business Name): SAMANTHA REPTOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W HIGGINS RD STE 950
SOUTH BARRINGTON IL
60010-9140
US

IV. Provider business mailing address

33 W HIGGINS RD STE 950
SOUTH BARRINGTON IL
60010-9140
US

V. Phone/Fax

Practice location:
  • Phone: 847-986-8010
  • Fax: 847-986-8106
Mailing address:
  • Phone: 847-986-8010
  • Fax: 847-986-8106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178022097
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: