Individual provider Active NPI

Sabrina Lefcochilos-Fogelquist, MD

  • Psychiatry Physician
  • Champaign, IL
National Provider Identifier
1740866409
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
36.175582 Issued in IL
Practice address
206 N Randolph St
Champaign, IL 61820-3949
Phone
(833) 351-8255
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 36.175582 IL Primary
Psychiatry Physician 2084P0800X 322702 NY

Addresses

Primary practice location

206 N Randolph St
Champaign, IL 61820-3949

Mailing address

PO Box 24449
New York, NY 10087-0589
Phone (833) 351-8255

Other practice location 1

109 W 27th St Rm 5S
New York, NY 10001-6208
Phone (833) 351-8255

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251204000260 IL Practitioner - Psychiatry 8426541822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Jefferson Medical College of Thomas Jefferson University, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

206 N Randolph St
2ND Floor Private Office 246
Champaign, IL 61820-3976
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36.175582ILMDPsychiatry Physician
322702NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Oct 6, 2025 Accepting new patients

Locations

206 N Randolph St
Ste 2
Champaign, IL 61820
Phone (540) 892-0910

250 Parkway Dr
Ste 150
Lincolnshire, IL 60069
Phone (847) 480-1346

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

Organizations & group practices 1

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1740866409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24449",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870589",
            "telephone_number": "833-351-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N RANDOLPH ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203949",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 W 27th St Rm 5S",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100016208",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEFCOCHILOS-FOGELQUIST",
        "first_name": "SABRINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "36.175582",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "322702",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.