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General NPI Number Information
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NPI Number | 1972476182
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Entity Type | Individual
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Provider Name | SAMANTHA STEVENS MSOT
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Gender | Female
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 8182 W GREENDALE AVE
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City | NILES
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State | IL
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Zip | 60714-2738
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Country | US
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Telephone | 847-318-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 1735 N PAULINA ST APT 407
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City | CHICAGO
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State | IL
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Zip | 60622-1461
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Country | US
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Telephone | 630-639-0842
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 056015122
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License Number State | IL
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