Donald Fagerson
Individual provider Active NPI Psychiatry Physician · Inverness, IL
NPI 1821110396 · NPPES record last updated Mar 31, 2015
Key facts
- NPI
- 1821110396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 036085741 (IL)
- Practice address
- 1644 W Colonial Pkwy
Inverness, IL 60067-1207 - Phone
- (847) 358-1588
- Fax
- (847) 358-1542
- NPI assigned
- Apr 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1644 W Colonial Pkwy
Inverness, IL 60067-1207
Phone (847) 358-1588
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041013000215 | IL | Practitioner - Psychiatry | 9638138035 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Donald L Fagerson MD SC | Psychiatry | Current |
Accepting new patients |
Locations
1644 W Colonial Pkwy
Inverness, IL 60067
Phone (847) 359-6200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036085741 | IL | Yes |
Addresses
Primary practice location
1644 W Colonial Pkwy
Inverness, IL 60067-1207
Mailing address
1644 W Colonial Pkwy
Inverness, IL 60067-1207
Phone (847) 358-1588
Other providers in Inverness, IL
- Donald L Fagerson MD SC
- Dragonfly Counseling and Wellness LLC
- Tiffany Ehardt
- Elizabeth Erin Engel
- David C. Evans
- Dylan Figueroa
- Alexandra Freeman
- Gonski Counseling PC
- Theresa L. Grimm
- Amy Guertin
All providers in Inverness, IL · Psychiatry Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.