Individual provider Active NPI

Raul Quinones Fabela, DMD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1285470666
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019035290 Issued in IL
Practice address
3600 W Belmont Ave
Chicago, IL 60618-8787
Phone
(773) 433-8300
NPI assigned
Jul 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019035290 IL Primary

Addresses

Primary practice location

3600 W Belmont Ave
Chicago, IL 60618-8787

Mailing address

208 May St
Bensenville, IL 60106-2519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019035290ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1285470666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 MAY ST",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601062519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606188787",
            "telephone_number": "773-433-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONES FABELA",
        "first_name": "RAUL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019035290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.