Mary Elaine Mabayag Fabricante, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.014844 Issued in IL

Practice address

401 W Lake St
Northlake, IL 60164-2435

Phone

(708) 223-0494

NPI assigned

Jun 18, 2009

Sex

Female

Sole proprietor

No

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.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • O Fallon, IL
  • NPI 1982018362

  IL, Physical Therapist

  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761
  NPD
• Affinity Rehab and Therapy Services LLC

  • Occupational Therapist
  • Chicago, IL
  • NPI 1346560349
  NPD (past)

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Powerback Rehabilitation LLC 600 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 15, 2025.

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1972730786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 CLOVER HILL CT",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600077126",
            "telephone_number": "773-474-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W LAKE ST",
            "city": "NORTHLAKE",
            "state": "IL",
            "postal_code": "601642435",
            "telephone_number": "708-223-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRICANTE",
        "first_name": "MARY ELAINE",
        "middle_name": "MABAYAG",
        "name_prefix": "Miss",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.014844",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11184024",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divine Providence Outpatient Therapy Services, LLC
• Dr Forecki and Associates, LTD
• Candice Dyer, FNP-C
• El Mejor Supplies LLC
• Elena Everhart
• Frederick John Fagan, O.D.
• Naji George Fakhouri, PHARMD
• Diane G Forecki, OD
• Elizabeth Kathleen Gatti, M.S. CCC-SLP
• Jithin George, PT, DPT

• All providers in Northlake, IL
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.