Provider Demographics
NPI:1841751666
Name:SINGER, SAMUEL MOSHE
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:MOSHE
Last Name:SINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 W SHERWIN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-1210
Mailing Address - Country:US
Mailing Address - Phone:240-354-6795
Mailing Address - Fax:216-249-9038
Practice Address - Street 1:2934 W SHERWIN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-1210
Practice Address - Country:US
Practice Address - Phone:240-354-6795
Practice Address - Fax:216-249-9038
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036156177208000000X
IL125074917208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics