Individual provider Active NPI

Derrick Farmer, M.D.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1568875672
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.144993 Issued in IL
Practice address
5841 S Maryland Ave # Mc3077
Chicago, IL 60637-1443
Phone
(773) 702-8595
NPI assigned
Jun 5, 2014
Last updated
Feb 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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 036.144993 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc3077
Chicago, IL 60637-1443

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.144993ILMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1568875672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC3077",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-702-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMER",
        "first_name": "DERRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-05",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.144993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.