The Fairbanks Group

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

THE FAIRBANKS GROUP

Doing business as

Dr. Colleen M. Fairbanks, LLC

Practice address

2625 Butterfield Rd Ste 103W
Oak Brook, IL 60523-3418

Phone

(630) 903-3854

NPI assigned

May 28, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Colleen Marie Fairbanks, PHD

Title

Licensed Clinical Psychologist

Phone

(630) 903-3854

Specialties & licenses 1

Addresses

Other names 1

• Dr. Colleen M. Fairbanks, LLC Doing business as

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1649846874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 S CHARLOTTE ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601482608",
            "telephone_number": "630-903-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 103W",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605233418",
            "telephone_number": "630-903-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAIRBANKS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "FAIRBANKS",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "630-903-3854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Colleen M. Fairbanks, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Tenhor, MSOT
• Marina Teruel
• Laura Ann Teven-Watkinson, ATC
• Jennifer Alexis Thal
• The Anxiety Treatment Center - Western Suburbs, LLC (The OCD & Anxiety Center)
• The Heartspeak Institute
• The Mental Difference
• Cynthia Lee Thelen, LCPC
• Violet Theodos, PH.D.
• Jeffrey Allen Thomas, MS,ATC/L

• Clinical Psychologist in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.