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General NPI Number Information
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NPI Number | 1568357747
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Entity Type | Individual
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Provider Name | SAMANTHA DEUCHLER
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Gender | Female
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 477 E BUTTERFIELD RD STE 408
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City | LOMBARD
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State | IL
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Zip | 60148-4881
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Country | US
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Telephone | 909-463-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 7753 VAN BUREN ST UNIT 507
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City | FOREST PARK
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State | IL
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Zip | 60130-4803
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Country | US
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Telephone | 708-616-8636
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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