DR. SAMANTHA CLAIRE CORDELL (NPI# 1619403458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619403458 |
| Entity Type | Individual |
| Full Name | DR. SAMANTHA CLAIRE CORDELL |
| Credential | DMD |
| Practice Address |
320 Lake St Oak Park IL 60302-2612 |
| Mailing Address |
495 Regalia Dr Inverness IL 60010-6443 |
| Practice Telephone | 0528708848 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2019-08-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
019.031103 | IL | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1740 W Taylor St, Chicago, IL 606127232 | 8666002273 |
| Street Address |
320 LAKE ST |
| City | OAK PARK |
| State | IL |
| Zip Code | 60302-2612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891886164 | Stephanie M Weller | Pediatrics | 320 Lake St, Oak Park, IL 60302-2612 | 2006-09-28 |
| 1497190532 | Darla Kim Dewolff | Nurse Practitioner | 320 Lake St, Oak Park, IL 60302-2612 | 2013-05-02 |
| 1265705990 | Family Service and Mental Health Center of Cicero | Voluntary or Charitable | 320 Lake St, Oak Park, IL 60302-2612 | 2012-02-10 |
| 1083746606 | Wanda Laszcz | Dentist | 320 Lake St, Oak Park, IL 60302-2612 | 2007-03-09 |
| 1134258916 | Oak Park River Forest Infant Welfare Society | Dentist | 320 Lake St, Oak Park, IL 60302-2612 | 2007-03-05 |
| 1104953827 | Fauzia Khan-alsikafi | Dentist | 320 Lake St, Oak Park, IL 60302-2612 | 2007-02-28 |
| 1518013432 | Elizabeth Ann Samore | Dentist | 320 Lake St, Oak Park, IL 60302-2612 | 2007-01-25 |
| 1659424018 | Jill Hoffmeyer Baskin | Dentist | 320 Lake St, Oak Park, IL 60302-2612 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306473244 | Tasha Kimberly Young | Counselor | 1216 N Austin Bvld, Oak Park, IL 60302 | 2020-03-23 |
| 1306492186 | Camiesa Rashida Rogers | Pharmacy Technician | 626 N Austin #7, Oak Park, IL 60302 | 2019-08-16 |
| 1326603887 | Right Choice Therapy LLC | Social Worker | 428 S. Scoville Avenue, Rear 1b, Oak Park, IL 60302 | 2019-05-09 |
| 1407328941 | Arundathi Bannur Suresh | Occupational Therapist | 3 Erie Court, West Suburban Medical Center, Oak Park, IL 60302 | 2018-12-21 |
| 1427537455 | Shannon Vogel | Occupational Therapist | 405 Home Ave Apt 207, Oak Park, IL 60302 | 2018-08-10 |
| 1568958726 | Loretto Hospital | Clinic/Center | 1000 Madison St, Oak Park, IL 60302 | 2018-07-10 |
| 1649783143 | Mary Joyce Arenas Lagatao | Nurse Practitioner | 101 Madison St, 3rd Floor, Oak Park, IL 60302 | 2017-11-07 |
| 1427578251 | Amanda Lam | Behavior Technician | 721 South Blvd., Suite 210, Oak Park, IL 60302 | 2017-06-22 |
| 1649790577 | Samantha Lotti | Acupuncturist | 1119 Pleasant St, Oak Park, IL 60302 | 2017-06-21 |
| 1770010480 | Robert Smith IIi | Behavior Technician | 412a S. Taylor Ave, Oak Park, IL 60302 | 2017-05-12 |
| Find all providers in zip 60302 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255452231 | John G Crawford Dds Ltd | Dentist | 505 N Ridgeland Ave, Oak Park, IL 60302-2328 | 2007-04-03 |
| 1144241258 | Yazdan Alami | Dentist | 368 Kanan Rd, Oak Park, CA 91377-1111 | 2006-07-22 |
| 1457680134 | Yazdan Alami, Dds, A Prof. Corp | Dentist | 368 Kanan Rd, Oak Park, CA 91377-1111 | 2009-12-09 |
| 1952422248 | John George Crawford IIi | Dentist | 505 N Ridgeland Ave, Oak Park, IL 60302-2328 | 2007-04-03 |
| 1962543694 | Jennifer Ellen Barry | Dentist | 368 Kanan Rd, Oak Park, CA 91377-1111 | 2007-02-08 |
| 1356365464 | Lisa Debs Brennan | Dentist | 368 Kanan Rd, Oak Park, CA 91377-1111 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709433 | Children's Center for Dentistry | Dentist | 314 Susan Dr, Normal, IL 61761-6206 | 2020-10-26 |
| 1073125746 | Jessica Mattern Dds, Pllc | Dentist | 326 W Burlington Ave, La Grange, IL 60525-2363 | 2020-08-23 |
| 1568925014 | Southern Illinois Pediatric Dentistry of Edwardsville | Dentist | 1419 Lewis Road, Suite 2, Edwardsville, IL 62025 | 2019-04-11 |
| 1710450754 | Drs Selberg & Rice Pllc | Dentist | 4945 Stone Falls Ctr Ste B, O Fallon, IL 62269-7801 | 2019-01-02 |
| 1821583634 | Dentalgenix | Dentist | 113 E Schaumburg Rd, Schaumburg, IL 60194-3518 | 2018-06-25 |
| 1528562253 | Rachel Vorwaller | Dentist | 1460 N Halsted St Ste 403, Chicago, IL 60642-2607 | 2018-03-19 |
| 1942740006 | Dhwani M. Joshi | Dentist | 195 S Rand Rd Ste 110, Lake Zurich, IL 60047-2205 | 2017-03-08 |
| 1316393390 | Erin Marie Petrik | Dentist | 2530 N Clark St, Apt 203, Chicago, IL 60614-4972 | 2016-05-10 |
| 1669839593 | Algonquin Kids Dentistry, Inc | Dentist | 4097 W Algonquin Rd, Algonquin, IL 60102-9401 | 2016-01-22 |
| 1720468598 | Mehedia Haque | Dentist | 2062 N Milwaukee Ave, Chicago, IL 60647 | 2015-06-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.