Robert a. Fajardo, M.D., S.C.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

36-39990 Issued in IL

Legal business name

ROBERT A. FAJARDO, M.D., S.C.

Practice address

122 So. Michigan Ave.
Suite 1413
Chicago, IL 60603-6191

Phone

(312) 922-6071

Fax

(312) 922-5656

NPI assigned

Nov 9, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Robert A. Fajardo, M.D.

Title

President

Phone

(312) 922-6071

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1257724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257724800000",
    "number": "1841527082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 SO. MICHIGAN AVE.",
            "address_2": "SUITE #1413",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036191",
            "telephone_number": "312-922-6071",
            "fax_number": "312-922-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 SO. MICHIGAN AVE.",
            "address_2": "SUITE 1413",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036191",
            "telephone_number": "312-922-6071",
            "fax_number": "312-922-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A. FAJARDO, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-09",
        "last_updated": "2009-11-09",
        "status": "A",
        "authorized_official_last_name": "FAJARDO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-922-6071",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "36-39990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; 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.