Annette Facinelli Boban, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085000395 Issued in IL

Practice address

3471 Green Bay Rd
North Chicago, IL 60064-3090

Phone

(847) 473-4357

Fax

(847) 578-3269

NPI assigned

Mar 16, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Annette Elaine Facinelli Other name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lodd Medical Group, S.C.

  • Family Medicine Physician
  • Vernon Hills, IL
  • NPI 1861536815
  Medicare reassignment
• Transitions Home Medical Group PLLC

  • Nurse Practitioner
  • Elk Grove Village, IL
  • NPI 1871890657
  Medicare reassignment
• Rosalind Franklin University Health

  • Durable Medical Equipment & Medical Supplies
  • North Chicago, IL
  • NPI 1982894911
  NPD (past)

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1568761591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600640610",
            "telephone_number": "847-578-8767",
            "fax_number": "847-578-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3471 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643090",
            "telephone_number": "847-473-4357",
            "fax_number": "847-578-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBAN",
        "first_name": "ANNETTE",
        "middle_name": "FACINELLI",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085000395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNETTE",
            "last_name": "FACINELLI",
            "middle_name": "ELAINE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Peter Alexander Bidny, D.D.S.
• Liz Bien-Aime
• Alisia Big
• Lorraine Black, BCD, CBE, PE, SBD
• Bernhard Emile Blom, PH.D.
• Jessica Marie Boh, PHARMD
• Terri Bohlman, MSW
• Kimberly Boit
• Michael Boler
• Venkata Jaya Madhuri Bongarala, PT

• Physician Assistant in North Chicago, IL
• Providers in North Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.