MR. PAUL V FAHRENBACH (NPI# 1699768416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699768416 |
| Entity Type | Individual |
| Full Name | MR. PAUL V FAHRENBACH |
| Credential | MD |
| Practice Address |
7447 W Talcott Ave Suite 209 Chicago IL 60631-3745 |
| Practice Telephone | 7736312728 |
| Practice Fax Number | 7736318083 |
| Mailing Telephone | 7736312728 |
| Mailing Fax Number | 7736318083 |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2016-11-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036078292 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RR MEDICARE | 110062166 | 01 |
| IL | PTAN | 976660 | 01 |
| IL | 036-078292 | 05 |
| Street Address |
7447 W TALCOTT AVE SUITE 209 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60631-3745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518960145 | Paul J Toussaint | Pediatrics | 7447 W Talcott Ave, Ste 467, Chicago, IL 60631-3715 | 2005-05-27 |
| 1194344721 | Alvin Au-yeung | Student in an Organized Health Care Education/Training Program | 7447 W Talcott Ave, Chicago, IL 60631-3745 | 2020-04-14 |
| 1639680267 | Jeffrey Moorhead | Physical Therapist | 7447 W Talcott Ave, Ste 500, Chicago, IL 60631-3716 | 2017-10-23 |
| 1770019796 | Brayton Kiedrowski | Student in an Organized Health Care Education/Training Program | 7447 W Talcott Ave, Chicago, IL 60631-3745 | 2017-05-11 |
| 1750818555 | Amber Ijaz | Family Medicine | 7447 W Talcott Ave, Resurrection Family Medicine, Ste. 182, Chicago, IL 60631-3745 | 2017-05-11 |
| 1548796683 | Jordan Oneill | Student in an Organized Health Care Education/Training Program | 7447 W Talcott Ave, Resurrection Family Medicine Suite 182, Chicago, IL 60631-3745 | 2017-05-10 |
| 1588190821 | Asha Anne | Student in an Organized Health Care Education/Training Program | 7447 W Talcott Ave, Resurrection Family Medicine Ste. 182, Chicago, IL 60631-3745 | 2017-05-05 |
| 1033644992 | Caryn Rachel Olshansky | Physician Assistant | 7447 W Talcott Ave, Suite 425, Chicago, IL 60631-3745 | 2017-04-27 |
| 1982139945 | Sabina Antonina Gal | Counselor | 7447 W Talcott Ave, Suite 448, Chicago, IL 60631-3745 | 2017-04-27 |
| 1538512934 | Aneta Zima | Nurse Practitioner | 7447 W Talcott Ave, Suite 248, Chicago, IL 60631-3745 | 2016-07-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427686609 | Martha Agnes Bissing | Student in an Organized Health Care Education/Training Program | Resurrection Medical Education, Karen Dwulat, 7435 W. Talcott Avenue, Chicago, IL 60631 | 2020-04-01 |
| 1497383434 | Kathryn Lee Hughes | Student in an Organized Health Care Education/Training Program | 7435 W Talcott Avenue, Medical Education, Karen Dwulat, Chicago, IL 60631 | 2020-03-27 |
| 1245723121 | Thomas Walsh | Student in an Organized Health Care Education/Training Program | Resurrection Family Medicine 7447 W Talcott Ave, Ste 182, Chicago, IL 60631 | 2018-06-14 |
| 1912411893 | Briggs Therapy Group, LLC | Social Worker | 6645 N Oliphant Ave Ste F, Chicago, IL 60631 | 2017-11-29 |
| 1013467257 | Elsa Methipara | Nurse Practitioner | 6429 N Ogallah, Chicago, IL 60631 | 2016-10-12 |
| 1477001766 | Djje Holdings LLC | Psychologist | 8609 W Bryn Mawr Ave Ste 204, Chicago, IL 60631 | 2016-09-14 |
| 1538512884 | Sprout Pediatric Dentistry | Dentist | 6036 North Northwest Highway, Chicago, IL 60631 | 2016-07-21 |
| 1417305137 | Christopher Louis Scodeller | Emergency Medicine | 7435 W. Talcott A, Presence Resurrection Medical Center, Chicago, IL 60631 | 2016-06-03 |
| 1518315464 | Corbin Barwegen | Emergency Medicine | 7435 W. Talcott Ave., Chicago, IL 60631 | 2016-06-01 |
| 1013304724 | Elliott T. Deweese | Dentist | 7447 W Talcott Ave., Suite 227, Chicago, IL 60631 | 2015-04-20 |
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| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104303296 | Amanda Israel | Internal Medicine | 5841 S Maryland Ave # 4076m410, Chicago, IL 60637-1443 | 2018-07-23 |
| 1447765888 | David Henoch Barch | Internal Medicine | 3431 N Leavitt St, Chicago, IL 60618-6013 | 2017-12-07 |
| 1205218658 | Ye Eun Kwak | Internal Medicine | 5841 S Maryland Ave Rm J-517, Chicago, IL 60637 | 2015-06-22 |
| 1154749042 | Joshua Michael Steinberg | Internal Medicine | 5841 S Maryland Ave # 4076, Chicago, IL 60637-1443 | 2014-03-28 |
| 1447599311 | Seymour Marshall Sabesin | Internal Medicine | 630 S Hermitage Ave, Suite 802, Chicago, IL 60612-3874 | 2013-02-12 |
| 1265796429 | Jonathan Mark Erlich | Internal Medicine | 7447 W Talcott Ave Ste 209, Chicago, IL 60631-3713 | 2012-07-02 |
| 1255628921 | Michael O Blackstone | Internal Medicine | 4103 N Harding Ave, Chicago, IL 60618-1913 | 2011-07-01 |
| 1346533213 | Amanda Guentner | Internal Medicine | 259 E Erie St Ste 2250, Chicago, IL 60611-3264 | 2011-05-25 |
| 1962795450 | Christine Chan | Internal Medicine | 429 W Melrose St, Apt. 2e, Chicago, IL 60657-3878 | 2011-05-17 |
| 1295039865 | Cemal Yazici | Internal Medicine | 840 S Wood Street Suite 718e, Chicago, IL 60612 | 2010-12-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.