Individual provider Active NPI

Nanette Y. Fabi, M.D.

  • Internal Medicine Physician
  • Lansing, IL
National Provider Identifier
1548269228
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036089814 Issued in IL
Practice address
18127 William St
Lansing, IL 60438-3921
Phone
(708) 474-8844
Fax
(708) 474-6135
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036089814 IL Primary

Addresses

Primary practice location

18127 William St
Lansing, IL 60438-3921

Mailing address

27702 Network PL
Chicago, IL 60673-1277
Phone (708) 862-7674

Other identifiers 3

IdentifierTypeStateIssuer
110139210OtherILRRM
036089814MedicaidIL
F400460536OtherILMEDICARE

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
I20041111000055 IL Practitioner - Internal Medicine 7517920473

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ucm Medical Group Sub, LLC Internal Medicine CurrentSince May 1, 2018 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

27702 Network Pl
Chicago, IL 60673

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

18127 William St
Lansing, IL 60438
Phone (708) 474-8844

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1548269228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27702 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731277",
            "telephone_number": "708-862-7674",
            "fax_number": "708-862-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18127 WILLIAM ST",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604383921",
            "telephone_number": "708-474-8844",
            "fax_number": "708-474-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABI",
        "first_name": "NANETTE",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036089814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "110139210",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089814",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "F400460536",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, IL

Sources for this page

Verify at the official NPI Registry.