Paul V Fahrenbach, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036078292 Issued in IL

Practice address

7447 W Talcott Ave
Suite 209
Chicago, IL 60631-3745

Phone

(773) 631-2728

Fax

(773) 631-8083

NPI assigned

Aug 26, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Internal MedicineAlso: Gastroenterology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Healthcare Illinois Medical Group LLCGroup PAC ID 5597275685, 278 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117
• Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pfahrenbach@gis.gwaydirect.com

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.

• Prime Healthcare Illinois Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Des Plaines, IL
  • NPI 1023837689
  Medicare reassignment Care Compare group NPD
• Gi Partners of Illinois, PLLC

  • Gastroenterology Physician
  • Libertyville, IL
  • NPI 1548613995
  Medicare reassignment NPD

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
• Saint Francis Hospital - Evanston LLC

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1982442398
  Care Compare affiliation

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1699768416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "SUITE 209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-631-2728",
            "fax_number": "773-631-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "SUITE 209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-631-2728",
            "fax_number": "773-631-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHRENBACH",
        "first_name": "PAUL",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036078292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110062166",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "976660",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-078292",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Patrick Fahey, DPT
• Meghan Fahey, DPT
• Abdel Fahmy, M.D.
• Dahlia Fahmy, PT
• Gregory J Fahrenbach, MD
• Fahy and Fahy Optometrist, LTD
• Adrienne Fahy
• Mary E. Fahy, M.S.
• Timothy J Fahy, O.D.
• Ilja Faibussowitsch, MD

• Gastroenterology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.