Individual provider Active NPI

Emma Cabusao, M.D.

  • Psychiatry Physician
  • Wheaton, IL
National Provider Identifier
1417911744
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036-098792 Issued in IL
Practice address
1725 S Naperville Rd
Suite 206
Wheaton, IL 60187-8155
Phone
(630) 653-6441
Fax
(630) 653-8409
NPI assigned
Apr 13, 2006
Last updated
Dec 30, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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 036-098792 IL Primary

Addresses

Primary practice location

1725 S Naperville Rd
Suite 206
Wheaton, IL 60187-8155

Mailing address

1725 S Naperville Rd
Suite 206
Wheaton, IL 60187-8155
Phone (630) 653-6441

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040626000025 IL Practitioner - Psychiatry 2769465376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesis Clinical ServicesGroup PAC ID 9739153347, 15 clinicians

Practice addresses (Care Compare)

1725 S Naperville Rd
Suite 206
Wheaton, IL 60189-5855
Phone (630) 653-6441

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-098792ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tricity Family Services CurrentSince Aug 16, 2010 Accepting new patients
Genesis Clinical Services CurrentSince Dec 1, 1998 Accepting new patients
Tricity Family Services CurrentSince Aug 16, 2010 Accepting new patients
Intermission Therapies, LTD. PastSince Nov 1, 2024 Accepting new patients

Locations

1120 Randall Ct
Geneva, IL 60134
Phone (630) 232-1070

1725 S Naperville Rd
Ste 2
Wheaton, IL 60189

1725 S Naperville Rd
Ste 206
Wheaton, IL 60189
Phone (630) 653-6441

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1417911744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 S NAPERVILLE RD",
            "address_2": "SUITE 206",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601878155",
            "telephone_number": "630-653-6441",
            "fax_number": "630-653-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 S NAPERVILLE RD",
            "address_2": "SUITE 206",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601878155",
            "telephone_number": "630-653-6441",
            "fax_number": "630-653-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABUSAO",
        "first_name": "EMMA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-098792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.