MICHAEL L FESSENDEN (NPI# 1023013638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023013638 |
| Entity Type | Individual |
| Full Name | MICHAEL L FESSENDEN |
| Credential | M.D. |
| Practice Address |
2003 W Fulton St 3rd Floor Chicago IL 60612-2345 |
| Practice Telephone | 7732924800 |
| Practice Fax Number | 7734863548 |
| Mailing Telephone | 7732924800 |
| Mailing Fax Number | 7734863548 |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2007-07-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 8219 | ND | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 43269-020 | WI | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | D66365 | MD | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 36118835 | IL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 2003016360 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
2003 W FULTON ST 3RD FLOOR |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-2345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114526910 | Elizabeth Fast | Dietitian, Registered | 2003 W Fulton St, Chicago, IL 60612-2345 | 2020-10-22 |
| 1568080901 | Margaret R Bratcher | Dietitian, Registered | 2003 W Fulton St, Chicago, IL 60612-2345 | 2020-07-13 |
| 1285255802 | Jessica Schumacher | Dietitian, Registered | 2003 W Fulton St, Chicago, IL 60612-2345 | 2020-05-05 |
| 1033740931 | Charlotte Gambla | Dietitian, Registered | 2003 W Fulton St, Chicago, IL 60612-2345 | 2020-01-29 |
| 1609413970 | Danielle Dicristofano | Dietitian, Registered | 2003 W Fulton St, Chicago, IL 60612-2345 | 2019-12-05 |
| 1679110381 | Stephanie Kulczycki | Dietitian, Registered | 2003 W Fulton St, Chicago, IL 60612-2345 | 2019-12-02 |
| 1902454242 | Rina Hisamatsu | Dietitian, Registered | 2003 W Fulton St, Chicago, IL 60612-2345 | 2019-08-29 |
| 1376004903 | Jena Bartholomy | Dietitian, Registered | 2003 W Fulton St, Chicago, IL 60612-2345 | 2019-03-27 |
| 1861952160 | Michelle Spleha | Nurse Practitioner | 2003 W Fulton St, Chicago, IL 60612-2345 | 2019-03-22 |
| 1881162667 | Trishna Joshi | Dietitian, Registered | 2003 W Fulton St, Suite 301, Chicago, IL 60612 | 2018-11-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1124645700 | Timothy Alan Williams Jr. | Family Medicine | 1625 E 75th St Fl 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1194340026 | Kaysha Lynne Ribao | Family Medicine | 2116 S Springfield Ave, Chicago, IL 60623-2465 | 2020-06-16 |
| 1932724341 | Toni Kurian | Family Medicine | 1550 S Indiana Ave Apt 407, Chicago, IL 60605-4822 | 2020-06-11 |
| 1528689486 | Thurman J Robertson | Family Medicine | 1950 W. Polk Street, 7th Floor, Chicago, IL 60612-3714 | 2020-05-01 |
| 1629697297 | Lyndsey Danielle Johnson | Family Medicine | 2804 W Walton St, Chicago, IL 60622-4450 | 2020-04-13 |
| 1730708884 | Iruoma Genevieve Nwangwu | Family Medicine | 1950 W Polk Street, Chicago, IL 60612-3714 | 2020-04-09 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.