SAMANTHA NICOLE VANDERSLICE MD
NPI 1184128647
Psychiatry & Neurology - Child & Adolescent Psychiatry in Chicago, IL

Q: What is Samantha Vanderslice's NPI number?

The NPI number for Samantha Vanderslice is 1184128647. It was assigned to this individual provider in the NPPES registry on March 20, 2018.

Q: What is Samantha Vanderslice's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Active since March 20, 2018PECOS EnrolledAccepts Medicare Assignment

1645 W JACKSON BLVD STE 603, CHICAGO, IL 60612(312) 942-0819 Get Directions Write a Review

NPPES record last updated: September 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 12, 2025, Sep 5, 2024, Aug 8, 2024 and 1 more (4 updates tracked since 2018).

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About Samantha Nicole Vanderslice Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA NICOLE VANDERSLICE MD (NPI 1184128647) is an individual child & adolescent psychiatry provider in Chicago, Illinois, licensed in Illinois (036-176914) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in Boston, and is a graduate of University Of Texas Medical School At Houston (2018).

NPPES Registry Identity

NPI1184128647

Entity TypeIndividualFemale

Primary Taxonomy2084P0804X

Provider Legal NameSAMANTHA NICOLE VANDERSLICECredential: MD

Location Address1645 W JACKSON BLVD STE 603Chicago, IL 60612-2643

Mailing Address1645 W Jackson Blvd Ste 603Chicago, IL 60612-2643 · (312) 942-0819

Phone(312) 942-0819

Sole ProprietorNo

Medical School CMSUniversity Of Texas Medical School At HoustonGraduated 2018

Enumeration DateMarch 20, 2018

Last NPPES UpdateSeptember 12, 20254 updates tracked since enumeration

NPPES CertifiedSeptember 12, 2025

✔ NPI 1184128647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

License✔ Licensed in IL · 036-176914

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 036-176914 (IL)

1645 W JACKSON BLVD STE 603, Chicago, IL 60612

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Secondary Practice Location 1

Location 155 Fruit StBoston, MA 02114-2621 · Phone (617) 726-2000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samantha Nicole Vanderslice Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193063451

PECOS Enrollment IDI20240912002669, I20250924001726

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER MORIUCHI

Psychologist (Clinical)