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NPI Code Detail

MEDICARE: SAMUEL HERMAN CHINN PMHNP-BC

MEDICARE: SAMUEL HERMAN CHINN PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner209034181IL

General Provider Information

NPI Number : 1295699379
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL HERMAN CHINN PMHNP-BC
Provider Business Mailing Address
First Line : 1221 N SWIFT RD
Second Line :
City : ADDISON
State : IL
Zip : 60101-6105
Country : US
Telephone Number : 708-374-7265
Fax Number :
Provider Business Practice Location Address
First Line : 1221 N SWIFT RD
Second Line :
City : ADDISON
State : IL
Zip : 60101-6105
Country : US
Telephone Number : 708-374-7265
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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