NPIMap

Organization Active NPI

Fabian Carbonell MD SC

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1578767935
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036098028 Issued in IL
Legal business name
FABIAN CARBONELL MD SC
Practice address
331 W Surf St Ste 708
Chicago, IL 60657-7227
Phone
(773) 649-4261
Fax
(872) 243-2843
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Authorized official

Name
Fabian Carbonell, MDNPI 1295705119
Title
President
Phone
(773) 649-4261

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 036098028 IL Primary

Addresses

Primary practice location

331 W Surf St Ste 708
Chicago, IL 60657-7227

Mailing address

PO Box 339
Winnetka, IL 60093-0339
Phone (773) 649-4261

Other identifiers 1

IdentifierTypeStateIssuer
036098028MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050913001117 IL Part B Supplier - Clinic/Group Practice 7416980172 Receives reassigned benefits from 16 practitioners
Practice locations: Evanston, IL; Chicago, IL

National Provider Directory

National Provider Directory

Locations

331 W Surf St
Ste 907
Chicago, IL 60657
Phone (773) 295-0707

2800 N Sheridan Rd
Ste 408
Chicago, IL 60657
Phone (773) 281-7711

331 W Surf St
Ste 708
Chicago, IL 60657
Phone (773) 649-4261

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787184000000",
    "number": "1578767935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 339",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600930339",
            "telephone_number": "773-649-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 W SURF ST STE 708",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577227",
            "telephone_number": "773-649-4261",
            "fax_number": "872-243-2843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FABIAN CARBONELL MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A",
        "authorized_official_last_name": "CARBONELL",
        "authorized_official_first_name": "FABIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-649-4261",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036098028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098028",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.