Provider Demographics
NPI:1598427817
Name:SCHAB, SAMANTHA (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SCHAB
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2646 N MARSHFIELD AVE APT 2R
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1026
Mailing Address - Country:US
Mailing Address - Phone:312-605-6724
Mailing Address - Fax:
Practice Address - Street 1:2000 N RACINE AVE STE 3300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-7008
Practice Address - Country:US
Practice Address - Phone:312-605-6724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150105447104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker