Ilja Faibussowitsch, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

036094678 Issued in IL

Practice address

2800 N Sheridan Rd
Suite 301
Chicago, IL 60657-6156

Phone

(773) 935-5556

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Pulmonary DiseaseAlso: Critical Care (Intensivists)

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Respiratory, Critical Care and Sleep Specialists, LLCGroup PAC ID 8729302054, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
• Community First Medical Center Hospital, Chicago, IL, CCN 140251
• Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252
• West Suburban Medical Center Hospital, Oak Park, IL, CCN 140049
• Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ifaibussowitsch251805@direct.myadvocateaurora.org
• FHIR API: https://fhir4.healow.com/fhir/r4/DEDDCA

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.

• Respiratory, Critical Care and Sleep Specialists, LLC

  • Pulmonary Disease Physician
  • Chicago, IL
  • NPI 1568887354

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Bonaventure Medical Foundation, LLC

  • Family Medicine Physician
  • Elk Grove Village, IL
  • NPI 1588775647
  NPD (past)

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

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Park Ridge, IL
  • NPI 1164539730
  Care Compare affiliation
• Community First Healthcare of Illinois, Inc

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033214416
  Care Compare affiliation
• Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1578932869
  Care Compare affiliation
• Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1770531600
  Care Compare affiliation
• Resilience Healthcare-West Suburban Medical Center, LLC

  • General Acute Care Hospital
  • Oak Park, IL
  • NPI 1619442266
  Care Compare affiliation
• 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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1740220193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N SHERIDAN RD",
            "address_2": "SUITE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576156",
            "telephone_number": "773-935-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N SHERIDAN RD",
            "address_2": "SUITE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576156",
            "telephone_number": "773-935-5556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3155 E Southern Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852045521",
            "country_code": "US",
            "telephone_number": "480-655-8040 x206",
            "fax_number": "480-655-1640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIBUSSOWITSCH",
        "first_name": "ILJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AZ",
            "license": "55021",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "55021",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "AZ",
            "license": "55021",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036094678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094678",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul V Fahrenbach, MD
• Fahy and Fahy Optometrist, LTD
• Adrienne Fahy
• Mary E. Fahy, M.S.
• Timothy J Fahy, O.D.
• Monty Faidley
• Melinda Faier, M.D.
• Braley Catherine Failor
• Margaret Fain
• Larry Faines, MD

• Pulmonary Disease Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pulmonary Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.