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SHAHRBANOO FADAVI D.D.S.,M.S.
NPI 1750461737
Dentist - Pediatric Dentistry in Skokie, IL

Active since October 16, 2006PECOS Enrolled
4833 CHURCH ST, 801 S. POLINA, SKOKIE, IL 60077(847) 673-7118 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Shahrbanoo Fadavi D.d.s.,m.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAHRBANOO FADAVI D.D.S.,M.S. (NPI 1750461737) is an individual pediatric dentistry provider in Skokie, Illinois and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750461737
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameSHAHRBANOO FADAVICredential: D.D.S.,M.S.
Location Address4833 CHURCH ST, 801 S. POLINASkokie, IL 60077-1357
Mailing Address2429 Meadow Dr NWilmette, IL 60091-2253
Phone(847) 673-7118
Sole ProprietorNo
Enumeration DateOctober 16, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1750461737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
4833 CHURCH ST, Skokie, IL 60077
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shahrbanoo Fadavi D.d.s.,m.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shahrbanoo Fadavi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Board Of Trustees Of The University Of Illinois
8.5 mi
Primary Care
3656 N HALSTED ST
Chicago, IL 60613
  • Reassigned Medicare billing, Illinois enrollment
  • 2,127 clinicians in this Medicare group
NPI 1588815401 (734) 726-4697

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60077 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BARRY K FREYDBERG DDS
Dentist (General Practice)
4833 CHURCH ST
SKOKIE, IL 60077
Cook County (847) 673-7118
DR. GERALD M. NOSKIN D.D.S.
Dentist (General Practice)
4833 CHURCH ST
SKOKIE, IL 60077
Cook County (847) 673-7118
DR. CYRIL SADOWSKY DDS
Dentist (Orthodontics and Dentofacial Orthopedics)
4833 CHURCH ST
SKOKIE, IL 60077
Cook County (847) 673-7118
MAY MAZEN MARIE
Dentist (General Practice)
4833 CHURCH ST
SKOKIE, IL 60077
Cook County (847) 673-7118
NORTH SUBURBAN DENTAL ASSOCIATES PC
Dentist (Oral and Maxillofacial Surgery)
4833 CHURCH ST
SKOKIE, IL 60077
Cook County (847) 673-7118
DR. NATALIA IZABELA BRZEZINSKI DMD
Dentist
4833 CHURCH ST
SKOKIE, IL 60077
Cook County (847) 673-7118
DR. SHAHAD ZOMA DMD
Dentist
4833 CHURCH ST
SKOKIE, IL 60077
Cook County (847) 673-7118
DR. ETHEL SUEMURA ALFARO
Dentist
4833 CHURCH ST
SKOKIE, IL 60077
Cook County (847) 673-7118

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shahrbanoo Fadavi's NPI number?

The NPI number for Shahrbanoo Fadavi is 1750461737. It was assigned to this individual provider in the NPPES registry on October 16, 2006.

Where is Shahrbanoo Fadavi located?

Shahrbanoo Fadavi practices at 4833 Church St 801 S. Polina, Skokie, IL 60077. The listed phone number is (847) 673-7118.

What is Shahrbanoo Fadavi's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Shahrbanoo Fadavi enrolled in Medicare?

Yes. Shahrbanoo Fadavi is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shahrbanoo Fadavi's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shahrbanoo Fadavi reassigns Medicare benefits to The Board Of Trustees Of The University Of Illinois (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shahrbanoo Fadavi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shahrbanoo Fadavi accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Guardian and Humana and 1 other insurer list Shahrbanoo Fadavi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shahrbanoo Fadavi was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.