Individual provider Active NPI

Maureen Fayen, M.D.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1528190907
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Practice address
405 N Wabash Ave
Suite 1815
Chicago, IL 60611-3591
Phone
(312) 222-0015
Fax
(312) 527-0849
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

405 N Wabash Ave
Suite 1815
Chicago, IL 60611-3591

Mailing address

405 N Wabash Ave
Suite 1815
Chicago, IL 60611-3591
Phone (312) 222-0015

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Feb 21, 2014 through Feb 21, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-065793ILMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528190907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE",
            "address_2": "SUITE 1815",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113591",
            "telephone_number": "312-222-0015",
            "fax_number": "312-527-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE",
            "address_2": "SUITE 1815",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113591",
            "telephone_number": "312-222-0015",
            "fax_number": "312-527-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYEN",
        "first_name": "MAUREEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.