Active NPI
Constantin Abuzatoaie, M.D.
- Psychiatry Physician
- Hoffman Estates, IL
National Provider Identifier
1477817062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036-137679
- Practice address
- 1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029 - Phone
- (847) 755-8090
- Fax
- (847) 843-7393
- NPI assigned
- Jun 27, 2012
- Last updated
- Jun 23, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 125062168 | IL | |
| Psychiatry Physician | 2084P0800X | 036-137679 | IL | Primary |
Addresses
Primary practice location
1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029
Mailing address
1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029
Phone (847) 755-8090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 13, 2021 through Sep 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-137679 | IL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amen Clinics, Inc Chicago | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
- Bannockburn, IL
- NPI 1134635618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466640000000",
"number": "1477817062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1786 MOON LAKE BLVD",
"address_2": "SUITE 104",
"city": "HOFFMAN ESTATES",
"state": "IL",
"postal_code": "601695029",
"telephone_number": "847-755-8090",
"fax_number": "847-843-7393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1786 MOON LAKE BLVD",
"address_2": "SUITE 104",
"city": "HOFFMAN ESTATES",
"state": "IL",
"postal_code": "601695029",
"telephone_number": "847-755-8090",
"fax_number": "847-843-7393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABUZATOAIE",
"first_name": "CONSTANTIN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-27",
"last_updated": "2016-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "125062168",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036-137679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hoffman Estates, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.