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General NPI Number Information
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NPI Number | 1043081227
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Entity Type | Individual
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Provider Name | SAMANTHA PAYTON CAMERON PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 10350 HALIGUS RD STE 220
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City | HUNTLEY
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State | IL
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Zip | 60142-9585
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Country | US
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Telephone | 847-802-7230
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Fax |
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Provider Business Mailing Address
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Address Line | 200 ROSEHALL DR UNIT 250
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City | LAKE ZURICH
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State | IL
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Zip | 60047-6266
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Country | US
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Telephone | 224-358-8688
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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