DR. JANE ELLEN SAMUELSON PH. D.
NPI 1346468394
Psychologist - Clinical in Chicago, IL

Q: What is Jane Samuelson's NPI number?

The NPI number for Jane Samuelson is 1346468394. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Q: What is Jane Samuelson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Jane Samuelson enrolled in Medicare?

No. Jane Samuelson has opted out of Medicare through May 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Jane Samuelson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 23, 2007Opted out of Medicare · through May 19, 2028

111 N WABASH AVE, SUITE 1704, CHICAGO, IL 60602(708) 524-1267 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Jane Ellen Samuelson Ph. D. NPPES

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

DR. JANE ELLEN SAMUELSON PH. D. (NPI 1346468394) is an individual clinical provider in Chicago, Illinois and active in the NPI registry since April 2007. She has opted out of Medicare through May 19, 2028.

NPPES Registry Identity

NPI1346468394

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. JANE ELLEN SAMUELSONCredential: PH. D.

Location Address111 N WABASH AVE, SUITE 1704Chicago, IL 60602-1903

Mailing Address208 S Maple Ave, Apt. 19Oak Park, IL 60302-3028 · (708) 524-1267

Phone(708) 524-1267

Sole ProprietorYes

Enumeration DateApril 23, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1346468394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

111 N WABASH AVE, Chicago, IL 60602

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jane Ellen Samuelson Ph. D. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 19, 2022 through May 19, 2028.

Opt-Out Effective DateMay 19, 2022

Opt-Out In Effect ThroughMay 19, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

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

DR. KATRINA I BROW AU.D.

Audiologist (Assistive Technology Supplier)

111 N WABASH AVE, SUITE 1618
CHICAGO, IL 60602

Cook County (312) 251-0100

MG DENTISTRY

Dentist (General Practice)

111 N WABASH AVE, 1820
CHICAGO, IL 60602

Cook County (312) 236-3633

ROBERT A. LEVINE, M.D., S.C.

Ophthalmology

111 N WABASH AVE, 2102
CHICAGO, IL 60602

Cook County (312) 332-2889

LAURA ESTRADA MA, LPC

Counselor (Mental Health)

111 N WABASH AVE
CHICAGO, IL 60602

Cook County (320) 295-6734

CANDACE COOK-BEY

Social Worker

111 N WABASH AVE
CHICAGO, IL 60602

Cook County (224) 277-1755

STEPHANIE SCHNAUFER

Dietitian, Registered

111 N WABASH AVE, SUITE #100, MAILBOX #3660
CHICAGO, IL 60602

Cook County (224) 616-0561

INCLUSIVE THERAPIES

Social Worker (Clinical)

111 N WABASH AVE
CHICAGO, IL 60602

Cook County (312) 487-1543

DR. JAMES C SHEININ MD

Internal Medicine (Endocrinology, Diabetes & Metabolism)

111 N WABASH AVE, #1216
CHICAGO, IL 60602

Cook County (312) 346-1891

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jane Samuelson's NPI number?

The NPI number for Jane Samuelson is 1346468394. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Where is Jane Samuelson located?

Jane Samuelson practices at 111 N Wabash Ave Suite 1704, Chicago, IL 60602. The listed phone number is (708) 524-1267.

What is Jane Samuelson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jane Samuelson enrolled in Medicare?

No. Jane Samuelson has opted out of Medicare through May 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jane Samuelson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.