Robert A Fajardo, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

03639990 Issued in IL

Practice address

122 So Michigan Ave
#1413
Chicago, IL 60603

Phone

(312) 922-6071

Fax

(312) 922-5656

NPI assigned

Oct 25, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

• Robert a. Fajardo, M.D., S.C.

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1841527082
  Authorized official Same address or phone

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1275617383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 SO MICHIGAN AVE",
            "address_2": "#1413",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60603",
            "telephone_number": "312-922-6071",
            "fax_number": "312-922-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 SO MICHIGAN AVE",
            "address_2": "#1413",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60603",
            "telephone_number": "312-922-6071",
            "fax_number": "312-922-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJARDO",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "03639990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC  BS",
            "identifier": "21601162",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Faith, PT, DPT
• Faithfully Aligning You Counseling and Wellness, PLLC
• Farah Faizan, MD
• Edward J Fajardo, PSYD
• Maricela Fajardo
• Ayotunde Fajembola
• Maria Fakhouri, PSYD
• Suzan Jamal Fakhoury, PA-C
• Sherene Fakhran, MD
• Sara Fakhri, LCPC

• Psychiatry Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.