Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fabienne Fify

Individual provider Gerontology Nurse Practitioner · NPI 1063263572

Fabienne Fify is a Nurse Practitioner in LA Porte, Indiana. Qualified in 2020, 6 years ago. Practices with Theoria Medical, a 342-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
6
Licensed in
IN
In the registry since
2024
Specialties on file
2

Practice location Address checks out

1700 I St
LA Porte, IN 46350-5750
Phone: (708) 288-5036
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence MF9072769 (IN)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 71015257A (IN)

Record details

NPI number1063263572
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 1, 2024
Last updated in NPPESMarch 1, 2025
Certification dateMarch 1, 2025
Mailing address1118 W 112th Pl, Chicago, IL 60643-4518

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Theoria Medical — 342 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount