MEDICARE: DR. SAMANTHA CHRISTINE HAESEMEYER PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	071.022489	IL

General Provider Information

NPI Number	:	1245037118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMANTHA CHRISTINE HAESEMEYER PSYD

Provider Business Mailing Address
First Line	:	33 N DEARBORN ST STE 800
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-3194
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 N DEARBORN ST STE 800
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-3194
Country	:	US
Telephone Number	:	224-223-2802
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2025
Last Update Date	:	01/12/2026

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