Pamela Fagen, REGISTERED DIETITIAN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164003018 Issued in IL

Practice address

2200 E Devon Ave Ste 309
Des Plaines, IL 60018-4505

Phone

(847) 708-4929

NPI assigned

Jul 13, 2014

Last updated

Jul 13, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Soul Care Services Inc

  dba Bridging Care Home Health Plus

  • Home Health Agency
  • Des Plaines, IL
  • NPI 1164735171
  NPD (past)

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

{
    "created_epoch": "1405209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405209600000",
    "number": "1790192698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8325 S HERMITAGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606204630",
            "telephone_number": "949-394-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E DEVON AVE STE 309",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600184505",
            "telephone_number": "847-708-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGEN",
        "first_name": "PAMELA",
        "name_prefix": "Ms.",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-13",
        "last_updated": "2014-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164003018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Escobedo
• Veronica Espinoza
• Raymund Espiritu, OTR/L
• Evoke Wellness at Chicago
• Erin Elizabeth Fabbri
• Fahey Medical Center
• Fahey Medical Center S.C.
• Umniyah R Faisal, RBT
• Holly Faletti
• Family Guidance Centers, Inc.

• Registered Dietitian in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2014; 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.