DR. MARC FAGAN (NPI# 1730626011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730626011 |
| Entity Type | Individual |
| Full Name | DR. MARC FAGAN |
| Credential | PSY.D. |
| Practice Address |
4101 N Ravenswood Ave. Chicago IL 60613 |
| Mailing Address |
1335 Deerfield Rd Deerfield IL 60015 |
| Practice Telephone | 7735725402 |
| Mailing Telephone | 8476512493 |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 071.006654 | IL | Behavioral Health & Social Service Providers |
| Street Address |
4101 N RAVENSWOOD AVE. |
| City | CHICAGO |
| State | IL |
| Zip Code | 60613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588261978 | Thorek Radiology Group Nfp | Radiology | 850 West Irving Park Road, Chicago, IL 60613 | 2020-10-08 |
| 1760034128 | Maryellen Karas Lajeunesse | Social Worker | 3930 N. Pine Grove Ave, #2403, Chicago, IL 60613 | 2019-07-15 |
| 1801366430 | Stephanie A Dykema | Psychologist | 4043 N Ravenswood Ave Suite 302, Chicago, IL 60613 | 2018-11-27 |
| 1487154191 | Alan Tsang | Counselor | 655 W Irving Park Rd Ste 203, Chicago, IL 60613 | 2018-02-19 |
| 1972015782 | Integrated Ortho, LLC. | Durable Medical Equipment & Medical Supplies | 3717 N. Ravenswood Ave, Suite 219w, Chicago, IL 60613 | 2017-11-02 |
| 1073048005 | Claire Jolly | Social Worker | 3701 N Ravenswood Ave Ste 301, Chicago, IL 60613 | 2017-04-27 |
| 1205385671 | Sara Turner | Psychologist | 3855 N Greenview Ave # 2a, Chicago, IL 60613 | 2016-09-27 |
| 1962955997 | Michelle Montero | Psychologist | 925 W Dakin St Apt 405, Chicago, IL 60613 | 2016-07-26 |
| 1063883494 | Athletico, Ltd | Physical Therapist | 3922 North Sheridan Rd, Chicago, IL 60613 | 2015-10-12 |
| 1669858767 | Jonathan Reed | Occupational Therapy Assistant | 700 W. Bittersweet Place, Chicago, IL 60613 | 2015-07-31 |
| Find all providers in zip 60613 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275265 | Susan Benjamin Feingold Psyd and Associates LLC | Psychologist | 1038 N Crosby St, Chicago, IL 60610-2404 | 2020-11-02 |
| 1013524818 | Lincoln Park Psychology, Inc. | Psychologist | 644 W Webster Ave # B, Chicago, IL 60614-3710 | 2020-09-25 |
| 1962016386 | Brittney Aubin | Psychologist | 2555 N Clark St Apt 201, Chicago, IL 60614-1722 | 2020-09-02 |
| 1235750860 | Dia Anjali Mason | Psychologist | 1234 N Kedzie Ave, Chicago, IL 60651-2408 | 2020-05-05 |
| 1811532880 | Emily Wolodiger | Psychologist | 1645 W Jackson Blvd Ste 302, Chicago, IL 60612-3227 | 2019-11-13 |
| 1518500099 | Allow Wellness LLC | Psychologist | 233 E Wacker Dr Apt 3901, Chicago, IL 60601-5115 | 2019-10-28 |
| 1619510914 | Keeshawna Brooks | Psychologist | 325 N Wells St Ofc 523, Chicago, IL 60654-7024 | 2019-10-20 |
| 1104468800 | Emotion-focused Therapy Chicago, LLC | Psychologist | 230 E Ohio St Ste 405, Chicago, IL 60611-5288 | 2019-10-14 |
| 1124660022 | Lynne Lieberman | Psychologist | 325 S Paulina St, Chicago, IL 60612-3206 | 2019-10-11 |
| 1003462821 | Michael Marek Maka | Psychologist | 820 W. Jackson Blvd, Suite 515, Chicago, IL 60607 | 2019-08-16 |
| 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.