Provider Demographics
NPI:1326624420
Name:POLHEMUS, SAMUEL EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:EDWARD
Last Name:POLHEMUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 S PAULINA ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3207
Mailing Address - Country:US
Mailing Address - Phone:312-942-5932
Mailing Address - Fax:
Practice Address - Street 1:325 S PAULINA ST STE 200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3207
Practice Address - Country:US
Practice Address - Phone:312-942-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-20
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR00694522084P0800X
IL036.1726852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty