Dr. Samantha R. Charles, DNP-C
Nurse Practitioner in Chicago, IL. Individual provider (NPI-1).
NPI number1982202206
StatusActive
Last updated in NPPESJan 30, 2023
Details
- NPI
- 1982202206
- Entity type
- Individual (NPI-1)
- Name
- Dr. Samantha R. Charles
- Credential
- DNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 9, 2020
- Certification date
- Jan 30, 2023
- Last updated
- Jan 30, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 209021761 | IL | Yes |
Practice location
675 N Saint Clair St Ste 21-100Chicago, IL 60611-5970
Phone 312-695-0990 · Fax 312-472-5270
Mailing address
675 N Saint Clair St Ste 21-100Chicago, IL 60611-5970
Phone 312-695-0990 · Fax 312-472-5270
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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