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NPI Code Detail

MEDICARE: SAMANTHA CANNING MD

MEDICARE: SAMANTHA CANNING MD
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
1207R00000XInternal Medicine Physician036169525IL
2207R00000XInternal Medicine Physician69636MN

General Provider Information

NPI Number : 1629606769
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA CANNING MD
Provider Business Mailing Address
First Line : 675 N SAINT CLAIR ST STE 18-200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-5929
Country : US
Telephone Number : 312-695-8630
Fax Number : 312-695-2857
Provider Business Practice Location Address
First Line : 675 N SAINT CLAIR ST STE 18-200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-5929
Country : US
Telephone Number : 312-695-8630
Fax Number : 312-695-2857
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2020
Last Update Date : 02/17/2026

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Directions to “ SAMANTHA CANNING MD” Practice Location

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