Johanne Theodule Fahy, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085003125 Issued in IL

Practice address

16450 104TH Ave
Orland Park, IL 60467-5413

Phone

(708) 349-0070

Fax

(708) 349-0077

NPI assigned

Oct 29, 2007

Sex

Female

Sole proprietor

No

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

Enrolled in IL, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Home Physicians LLCGroup PAC ID 4981988771, 81 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

26.84 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

89.46

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Community Home Physicians, LLC

  • Physical Medicine & Rehabilitation Physician
  • Oakbrook Terrace, IL
  • NPI 1568909505

  IL

  Medicare reassignment Care Compare group
• Siloam Home and Wound Care Physicians Inc

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1861814915

  IL

  Medicare reassignment
• Acute Care Specialists II, LTD

  • Emergency Medicine Physician
  • Glendale Heights, IL
  • NPI 1205974433
  NPD (past)
• Birinder S Marwah MD LTD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1497784235
  NPD (past)
• Elmhurst Memorial Healthcare

  • Multi-Specialty Clinic/Center
  • Elmhurst, IL
  • NPI 1457493454
  NPD (past)
• Emergency Healthcare Physicians, LTD.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Hinsdale, IL
  • NPI 1881620243
  NPD (past)
• Physicians at Your Door Incorporation

  • Family Medicine Physician
  • Willowbrook, IL
  • NPI 1396174124
  NPD (past)
• Windy City Emergency Physicians

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1467490979
  NPD (past)

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1821277682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16450 104TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675413",
            "telephone_number": "708-349-0070",
            "fax_number": "708-349-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16450 104TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675413",
            "telephone_number": "708-349-0070",
            "fax_number": "708-349-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODULE FAHY",
        "first_name": "JOHANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2022-09-15",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085003125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Madi Way LLC
• The McGrath Clinic
• The McGrath Clinic S C
• The Therapy Center
• The Thriving You, PLLC
• Therapeutic Pain Solutions, LLC
• Therasys Corporation
• Thomas G. Mulvey , M.S., P.T., M.B.a., P.C.
• Thomas W. Roland, D.C., LTD.
• Anu Thomas, OTR

• All providers in Orland Park, IL
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.