Individual provider Active NPI

Fe A. Velasco, M.D.

  • Psychiatry Physician
  • Schaumburg, IL
National Provider Identifier
1649506403
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036065750 Issued in IL
Practice address
1340 Remington Rd
Suite K
Schaumburg, IL 60173-4830
Phone
(847) 882-8908
NPI assigned
Jun 3, 2006
Reactivated
Oct 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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 036065750 IL Primary

Addresses

Primary practice location

1340 Remington Rd
Suite K
Schaumburg, IL 60173-4830

Mailing address

1340 Remington Rd
Suite K
Schaumburg, IL 60173-4830
Phone (847) 882-8908

Other identifiers 1

IdentifierTypeStateIssuer
036065750MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036065750ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Suburban Multi-Specialty Medical Services Association SC Psychiatry Past Accepting new patients
Crimson Ark Medical Services, Inc. Past Accepting new patients
Schaumburg Interventions & Counseling Center Past Accepting new patients

Organizations & group practices 3

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257120000000",
    "number": "1649506403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 REMINGTON RD",
            "address_2": "SUITE K",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734830",
            "telephone_number": "847-882-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 REMINGTON RD",
            "address_2": "SUITE K",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734830",
            "telephone_number": "847-882-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "replacement_npi": "1649506403",
        "last_name": "VELASCO",
        "first_name": "FE",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2009-11-02",
        "deactivation_date": "2009-09-14",
        "reactivation_date": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036065750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065750",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.