Di Fan, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

036123598 Issued in IL

Practice address

800 Biesterfield Rd Ste 201B
Elk Grove Village, IL 60007-3372

Phone

(847) 593-8460

Fax

(224) 235-4652

NPI assigned

Jun 22, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Thoracic SurgeryAlso: General Surgery

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vein Clinics of Chicago LLCGroup PAC ID 1153572383, 9 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 29)

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vein Clinics of Chicago LLC

  • Vascular Surgery Physician
  • Chicago, IL
  • NPI 1386904621

  IL

  Medicare reassignment Care Compare group NPD
• Congress Vein Clinic LLC

  • Trauma Surgery Physician
  • Chicago, IL
  • NPI 1467986901

  IL

  Medicare reassignment NPD
• Illinois Phlebology Associates SC

  • Surgery Physician
  • Orland Park, IL
  • NPI 1154378040

  IL

  Medicare reassignment NPD
• North Shore Vein Clinics LLC

  • Vascular Surgery Physician
  • Northbrook, IL
  • NPI 1841547098

  IL

  Medicare reassignment NPD
• Northwest Vein Clinics LLC

  • Vascular Surgery Physician
  • Elk Grove Village, IL
  • NPI 1578810651

  IL

  Medicare reassignment NPD
• USA Vascular Centers of Chicago, LLC

  • Vascular Surgery Physician
  • Northbrook, IL
  • NPI 1174995674

  IL

  Medicare reassignment NPD
• Congress Vascular Center LLC

  • Vascular Surgery Physician
  • Chicago, IL
  • NPI 1396267324

  IL

  Medicare reassignment
• Elmwood Park Vascular Center LLC

  • Vascular Surgery Physician
  • Elmwood Park, IL
  • NPI 1043731300
  NPD (past)
• Premiere Anesthesia Group LLC

  • Certified Registered Nurse Anesthetist
  • Park Ridge, IL
  • NPI 1720467392
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1023245693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 WAINWRIGHT DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621900",
            "telephone_number": "847-593-8460",
            "fax_number": "224-235-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE 201B",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073372",
            "telephone_number": "847-593-8460",
            "fax_number": "224-235-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "DI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036123598",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "DC",
            "license": "MD038009",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036123598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036123598",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MD038009",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sorrel E. Fagel, MD
• Precilla Fajardo, MSW
• Jessica Falcinelli, ATC
• Family Chiropractic Health Center, PC
• Family Medical Clinic Inc.
• Tala Faraj
• Tanahri Favela
• Christine Furmanek Feighery, APN-CNP
• Fibromyalagia Treatment Centers of America
• Elizabeth L Fillmore

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.