Individual provider Active NPI

Katherine Backes, M.D.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1740544667
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
125061968 Issued in IL
Practice address
420 E Superior St
Rubloff 12TH Floor
Chicago, IL 60611-4494
Phone
(312) 503-7975
NPI assigned
Jun 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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 125061968 IL Primary

Addresses

Primary practice location

420 E Superior St
Rubloff 12TH Floor
Chicago, IL 60611-4494

Mailing address

446 E Ontario St
Suite 7-100
Chicago, IL 60611-4418
Phone (312) 926-8058

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125061968ILMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1740544667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 E ONTARIO ST",
            "address_2": "SUITE 7-100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114418",
            "telephone_number": "312-926-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E SUPERIOR ST",
            "address_2": "RUBLOFF 12TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114494",
            "telephone_number": "312-503-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKES",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125061968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.