Provider Demographics
NPI:1194189241
Name:POSCH, SAMANTHA MARIE (APN)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:MARIE
Last Name:POSCH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 NIGHTSHADE LN
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60404-9542
Mailing Address - Country:US
Mailing Address - Phone:630-881-0504
Mailing Address - Fax:
Practice Address - Street 1:801 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-7430
Practice Address - Country:US
Practice Address - Phone:630-527-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209014145363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner