Individual provider Active NPI

Farhad Daniel Hayatghaib, M.D.

  • Psychiatry Physician
  • North Chicago, IL
National Provider Identifier
1376912915
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
125068549 Issued in IL
Practice address
3001 Green Bay Rd.
BLDG 133Ef 3Rd Floor - Outpt MH Clinic
North Chicago, IL 60064-3048
Phone
(224) 610-3744
NPI assigned
Sep 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125068549 IL Primary

Addresses

Primary practice location

3001 Green Bay Rd.
BLDG 133Ef 3Rd Floor - Outpt MH Clinic
North Chicago, IL 60064-3048

Mailing address

3001 Green Bay Rd.
BLDG 133Ef 3Rd Floor - Outpt MH Clinic
North Chicago, IL 60064-3048
Phone (224) 610-3744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1376912915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD.",
            "address_2": "BLDG 133EF 3RD FLOOR - OUTPT MH CLINIC",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048",
            "telephone_number": "224-610-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD.",
            "address_2": "BLDG 133EF 3RD FLOOR - OUTPT MH CLINIC",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048",
            "telephone_number": "224-610-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYATGHAIB",
        "first_name": "FARHAD",
        "middle_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-24",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125068549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chicago, IL

Sources for this page

Verify at the official NPI Registry.