Individual provider Active NPI

Vanessa D. Fabbre, L.C.S.W

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1780894782
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
150011018 Issued in IL
Practice address
2740 N Pine Grove Ave
Unit 3a
Chicago, IL 60614-6137
Phone
(773) 428-3873
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 150011018 IL Primary

Addresses

Primary practice location

2740 N Pine Grove Ave
Unit 3a
Chicago, IL 60614-6137

Mailing address

2740 N Pine Grove Ave
Unit 3a
Chicago, IL 60614-6137
Phone (773) 428-3873

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
150011018ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1780894782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 N PINE GROVE AVE",
            "address_2": "UNIT 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146137",
            "telephone_number": "773-428-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 N PINE GROVE AVE",
            "address_2": "UNIT 3A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146137",
            "telephone_number": "773-428-3873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABBRE",
        "first_name": "VANESSA",
        "middle_name": "D.",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "150011018",
            "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 Jan 14, 2013; 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.