Provider Demographics
NPI:1053113209
Name:CALDERON, SAMARIA
Entity type:Individual
Prefix:
First Name:SAMARIA
Middle Name:
Last Name:CALDERON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MARQUETTE ST
Mailing Address - Street 2:
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-2160
Mailing Address - Country:US
Mailing Address - Phone:312-439-8747
Mailing Address - Fax:
Practice Address - Street 1:1950 W ROSCOE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1030
Practice Address - Country:US
Practice Address - Phone:847-420-1556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula