MEDICARE: SAMARA YOUNG OT

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	225X00000X	Occupational Therapist	31008952A	IN

General Provider Information

NPI Number	:	1710841242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMARA YOUNG OT

Provider Business Mailing Address
First Line	:	2122 YORK RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1925
Country	:	US
Telephone Number	:	803-812-3656
Fax Number	:

Provider Business Practice Location Address
First Line	:	1003 MILL POND DR STE C
Second Line	:
City	:	GREENCASTLE
State	:	IN
Zip	:	46135-2609
Country	:	US
Telephone Number	:	765-653-8494
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	01/16/2026

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Directions to “ SAMARA YOUNG OT” Practice Location

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