Active NPI
Anne Marie Fabricius, D.M.D.
- Dentist
- Chicago, IL
National Provider Identifier
1326355249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.028395
- Practice address
- 400 N McClurg CT
#1608
Chicago, IL 60611-4323 - Phone
- (847) 208-3340
- NPI assigned
- Sep 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.028395 | IL | Primary |
| General Practice Dentistry | 1223G0001X | 019.028395 | IL |
Addresses
Primary practice location
400 N McClurg CT
#1608
Chicago, IL 60611-4323
Mailing address
400 N McClurg CT
#1608
Chicago, IL 60611-4323
Phone (847) 208-3340
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.028395 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284336000000",
"number": "1326355249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N MCCLURG CT",
"address_2": "#1608",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606114323",
"telephone_number": "847-208-3340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N MCCLURG CT",
"address_2": "#1608",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606114323",
"telephone_number": "847-208-3340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABRICIUS",
"first_name": "ANNE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-13",
"last_updated": "2010-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.028395",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.028395",
"primary": false
}
],
"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 Sep 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.