Provider Demographics
NPI:1043081227
Name:CAMERON, SAMANTHA PAYTON (PA-C)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:PAYTON
Last Name:CAMERON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ROSEHALL DR UNIT 250
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-6266
Mailing Address - Country:US
Mailing Address - Phone:224-358-8688
Mailing Address - Fax:
Practice Address - Street 1:10350 HALIGUS RD STE 220
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9585
Practice Address - Country:US
Practice Address - Phone:847-802-7230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical