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NPI Code Detail

MEDICARE: SAMANTHA DUDEK

MEDICARE: SAMANTHA DUDEK
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
1101YM0800XMental Health Counselor178.022860IL

General Provider Information

NPI Number : 1831039114
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA DUDEK
Provider Business Mailing Address
First Line : 22416 MERRITTON RD
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-5159
Country : US
Telephone Number : 815-600-9970
Fax Number :
Provider Business Practice Location Address
First Line : 10081 W LINCOLN HWY
Second Line :
City : FRANKFORT
State : IL
Zip : 60423-1272
Country : US
Telephone Number : 815-313-2100
Fax Number : 815-345-3177
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2026
Last Update Date : 03/30/2026

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Directions to “ SAMANTHA DUDEK ” Practice Location

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