| Fabian Carbonell Md Sc | |
|
331 W Surf St Ste 708 Chicago IL 60657-7227 | |
| (773) 649-4261 | |
| (872) 243-2843 |
| Full Name | Fabian Carbonell Md Sc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 331 W Surf St Ste 708, Chicago, Illinois |
| Authorized Official Name and Position | Fabian Carbonell (PRESIDENT) |
| Authorized Official Contact | 7736494261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fabian Carbonell Md Sc 331 W Surf St Ste 708 Chicago IL 60657-7227 Ph: (773) 649-4261 | Fabian Carbonell Md Sc 331 W Surf St Ste 708 Chicago IL 60657-7227 Ph: (773) 649-4261 |
| NPI Number | 1578767935 |
|---|---|
| Provider Enumeration Date | 06/12/2007 |
| Last Update Date | 11/17/2023 |
| Certification Date | 11/17/2023 |
| Medicare PECOS PAC ID | 7416980172 |
|---|---|
| Medicare Enrollment ID | O20050913001117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578767935 | NPI | - | NPPES |
| 036098028 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036098028 (Illinois) | Primary |
| Provider Name | Fabian E Carbonell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295705119 PECOS PAC ID: 4789617465 Enrollment ID: I20101117000858 |
| Provider Name | Marcos Modiano Esquenazi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699903336 PECOS PAC ID: 9931340221 Enrollment ID: I20130730000058 |
| Provider Name | Karen L Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326476433 PECOS PAC ID: 9133359292 Enrollment ID: I20140311001677 |
| Provider Name | Patricia Grayson-canty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841768660 PECOS PAC ID: 9830434497 Enrollment ID: I20181231000732 |
| Provider Name | Stewart Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639698244 PECOS PAC ID: 5890032635 Enrollment ID: I20200915001010 |
| Provider Name | Antonia Wanjiru Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164921094 PECOS PAC ID: 0042621344 Enrollment ID: I20201117002278 |
| Provider Name | Kim Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841729985 PECOS PAC ID: 0042582835 Enrollment ID: I20210311000508 |
| Provider Name | Pipelayo Grace Akinyemi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134878051 PECOS PAC ID: 3072989318 Enrollment ID: I20221012000687 |
| Provider Name | Danyatta Akindunbi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902535156 PECOS PAC ID: 2365812716 Enrollment ID: I20221230000922 |
| Provider Name | Joseph Olusola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649907536 PECOS PAC ID: 4587940853 Enrollment ID: I20230105001126 |
| Provider Name | Modupe O Adefeso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134832512 PECOS PAC ID: 0446611347 Enrollment ID: I20230725001062 |
| Provider Name | Theresa A Olusola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447943154 PECOS PAC ID: 2769768035 Enrollment ID: I20231121003285 |
| Provider Name | Ganiu Joko Ajakaiye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386328524 PECOS PAC ID: 2062860596 Enrollment ID: I20231122001170 |
| Provider Name | Abidemi Oluwakemi Balogun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205605235 PECOS PAC ID: 3173975778 Enrollment ID: I20240119000372 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
Young Adult Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |