Active NPI 1013610971 Individual Practitioner Female Practitioner

Samantha Jerusal

Nurse Practitioner - Pediatrics • Chicago, IL

Professional Overview & Biography Verified Profile Summary

Samantha Jerusal is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Chicago, IL. Practice services are available at 2418 W DIVISION ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2418 W Division St

Chicago, IL 606222940

Telephone 3126663494

Associated Practice Facility / Clinic

🏢 City Of Chicago Facility NPI 1245232628

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Chicago, IL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 11.0 Yrs

State Avg: 9.5 Yrs

Regional Practice Density

323 Specialists

Practicing in Chicago, IL (694 Statewide)

Telehealth Adoption Rate

0.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-09-05

Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License IL 209.028195

Definition to come...

Registered Nurse - Pediatrics

NUCC Taxonomy Code: 163WP0200X

State License OH 501051

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Silvia Diaz , LCSW

Social Worker - Clinical

NPI 1003204686

Licensed Clinical Social Worker

Nida Bajwa

Family Medicine

NPI 1033744081

Dr. Preiyaa Gopinath , MD

Internal Medicine

NPI 1043746449

Doctor of Medicine (M.D.)

Carla Villarreal

Family Medicine

NPI 1043779960

Dr. Nicole Runkle , MD

Family Medicine

NPI 1043834252

Doctor of Medicine (M.D.)

Simone Rowen , CNM

Advanced Practice Midwife

NPI 1043962103

Certified Nurse Midwife

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location September 05, 2023

Registered at 2418 W DIVISION ST, CHICAGO, IL 606222940 (Tel: 3126663494)

📍

Updated Business Mailing Address September 05, 2023

Registered at 2418 W DIVISION ST, CHICAGO, IL 606222940 (Tel: 3126663494)

✅

NPI Profile Active March 22, 2023

NPI status registered as active in NPPES database

📍

Updated Practice Location March 22, 2023

Registered at 630 CHILDRENS DR, COLUMBUS, OH 432052649 (Tel: 6147222000)

📍

Updated Business Mailing Address March 22, 2023

Registered at 934 DEACON CIR, COLUMBUS, OH 432142394 (Tel: 6149303623)

👤

Provider Name / Credentials Updated March 22, 2023

Recorded as SAMANTHA JERUSAL

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 22, 2023

Registered Nurse (License #501051 in OH)

🟢

Initial NPI Registration & Enumeration March 22, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1013610971

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 22, 2023

Last Update: September 05, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2418 W Division St

Chicago, IL 606222940

Phone: 3126663494

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.