Elizabeth Nord Fahrenbach, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

125.056349 Issued in IL

Practice address

7411 N Milwaukee Ave
Niles, IL 60714-3707

Phone

(773) 763-6000

Fax

(773) 763-6000

NPI assigned

Jun 18, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

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

Specialty

Dermatology

Education

Loyola University of Chicago, Stritch School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Branch Dermatology LLCGroup PAC ID 8921220914, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• North Branch Dermatology LLC

  • Dermatology Physician
  • Niles, IL
  • NPI 1154721348
  Medicare reassignment Care Compare group NPD Authorized official
• Kidney and Hypertension Consultants, S.C.

  • Nephrology Physician
  • Chicago, IL
  • NPI 1255453528
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Resurrection Medical Center - Chicago LLC

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1811735228
  Care Compare affiliation

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1609003557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7411 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143707",
            "telephone_number": "773-763-6000",
            "fax_number": "773-763-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143707",
            "telephone_number": "773-763-6000",
            "fax_number": "773-763-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHRENBACH",
        "first_name": "ELIZABETH",
        "middle_name": "NORD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "60769-20",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WI",
            "license": "60769-20",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "WI",
            "license": "60769-20",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "WI",
            "license": "60769-20",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "WI",
            "license": "60769-20",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "125.056349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Gibbs Ethington, M.D.
• Exam Corp (Exam Corp Lab)
• Expert Claims Medical Billing
• Eyedoctors P.C.
• Eyedoctors PC
• Gary Richard Fahrenbach, M.D.
• Holly R Fak, LCSW
• Walter S Falkowski, MD
• Fanan Mustafa Falouji, M.D.
• Family Home Caregivers Inc

• Dermatology Physician in Niles, IL
• Providers in Niles, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.