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Individual

DR. ARNOLD C. SAMUELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
636 CHURCH ST, SUITE 418, EVANSTON, IL 60201-4508
(847) 475-0665
(847) 475-0665
Mailing address
636 CHURCH ST, SUITE 418, EVANSTON, IL 60201-4508
(847) 475-0665
(847) 475-0665

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
IL
2084P0804X
Child & Adolescent Psychiatry Physician
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0021604076
BLUE SHIELD PROVIDER #
IL
Enumeration date
04/17/2007
Last updated
10/01/2007
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