Samantha Lauren Wallenberg, MS, OTD, OTR/L is a
Occupational Therapist based in Prophetstown, Illinois. Samantha Lauren Wallenberg is licensed to practice in Illinois (license number 056.013694) and her current practice location is
310 Mosher Dr, Prophetstown, Illinois. She can be reached at her office (for appointments etc.) via phone at
(309) 525-0231.
NPI number for Samantha Lauren Wallenberg is 1306682208 and her current mailing address is 2536 W Cortez St Apt Bf, Chicago, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1306682208.
Healthcare Provider's Profile
Full Name | Samantha Lauren Wallenberg |
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Gender | Female |
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Speciality | Occupational Therapist |
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Location | 310 Mosher Dr, Prophetstown, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1306682208
- Provider Enumeration Date: 07/01/2024
- Last Update Date: 07/01/2024
Medical Identifiers
Medical identifiers for Samantha Lauren Wallenberg such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1306682208 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225X00000X | Occupational Therapist | 056.013694 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samantha Lauren Wallenberg is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Samantha Lauren Wallenberg, MS, OTD, OTR/L 2536 W Cortez St Apt Bf, Chicago, IL 60622-3456 Ph: (224) 595-8744 | Samantha Lauren Wallenberg, MS, OTD, OTR/L 310 Mosher Dr, Prophetstown, IL 61277-1001 Ph: (309) 525-0231 |
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