Individual provider Active NPI

Abra Leigh Fant, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1760774921
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036138001 Issued in IL
Practice address
211 E Ontario St Ste 200
Chicago, IL 60611-3284
Phone
(312) 694-7000
NPI assigned
May 6, 2011
Last updated
Jul 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036138001 IL Primary

Addresses

Primary practice location

211 E Ontario St Ste 200
Chicago, IL 60611-3284

Mailing address

211 E Ontario St Ste 200
Chicago, IL 60611-3284
Phone (312) 694-7000

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
I20150730012305 IL Practitioner - Emergency Medicine 2567776859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

680 N Lake Shore Dr
Suite 810
Chicago, IL 60611-8700
Phone (312) 926-6146

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036138001ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2015 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2015 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

211 E Ontario St
Ste 200
Chicago, IL 60611
Phone (312) 694-7000

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

680 N Lake Shore Dr
Ste 810
Chicago, IL 60611
Phone (312) 926-8811

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1760774921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E ONTARIO ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113284",
            "telephone_number": "312-694-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E ONTARIO ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113284",
            "telephone_number": "312-694-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANT",
        "first_name": "ABRA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-06",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036138001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.