DR. FADI M MUSTAPHA (NPI# 1508801986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508801986 |
| Entity Type | Individual |
| Full Name | DR. FADI M MUSTAPHA |
| Credential | M.D. |
| Practice Address |
215 E 1st St Dixon IL 61021 |
| Mailing Address |
215 E 1st St Dixon IL 61021-3175 |
| Practice Telephone | 8152855843 |
| Practice Fax Number | 8152855846 |
| Mailing Telephone | 8152855843 |
| Mailing Fax Number | 8152855846 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2018-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036-115681 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ILLINOIS MEDICAL LICENSE | 036-115681 | 01 |
| IL | MEDICARE | K28334 | 01 |
| Street Address |
215 E 1ST ST |
| City | DIXON |
| State | IL |
| Zip Code | 61021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912978222 | Monther F El Bzour | Internal Medicine | 215 E 1st St, Ste 214, Dixon, IL 61021 | 2006-01-27 |
| 1609474097 | Maggie Helen Connors | Nurse Practitioner | 215 E 1st St, Dixon, IL 61021-3166 | 2020-10-16 |
| 1770145849 | Saima Sardar | Podiatrist | 215 E 1st St, Dixon, IL 61021-3166 | 2019-06-28 |
| 1447812508 | Kanika Kochhar | Podiatrist | 215 E 1st St, Dixon, IL 61021-3166 | 2019-06-28 |
| 1053763664 | Kyle Swanson | Podiatrist | 215 E 1st St, Suite 310, Dixon, IL 61021-3166 | 2016-07-07 |
| 1558718650 | Bridgette Ann Woodall | Nurse Practitioner | 215 E 1st St, Dixon, IL 61021-3166 | 2016-05-18 |
| 1730553306 | Alissa Kirchner | Speech-Language Pathologist | 215 E 1st St, Dixon, IL 61021-3166 | 2015-11-19 |
| 1215338157 | Steven Yeschek | Podiatrist | 215 E 1st St, Dixon, IL 61021-3166 | 2014-09-10 |
| 1144431289 | Patricia J Geisz | Physical Therapist | 215 E 1st St, Commerce Towers, Suite 318-319, Dixon, IL 61021-3166 | 2007-05-24 |
| 1518178284 | Deb A Bowers | Physical Therapy Assistant | 215 E 1st St, Dixon, IL 61021-3166 | 2007-05-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331082 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1600 South Galena Ave, Dixon, IL 61021 | 2019-05-12 |
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1518485432 | Madeline Luniewicz | Counselor | 325 Il-2, Dixon, IL 61021 | 2017-08-30 |
| 1669992566 | Nicole Marie Shaffer | Specialist/Technologist | 650 Reynoldswood Road, Dixon, IL 61021 | 2017-06-21 |
| 1346660446 | Lydia Sitter | Audiologist | 215 3. 1st Street, Suite 317, Ksb Medical Group, Dixon, IL 61021 | 2014-04-16 |
| 1053600080 | Janet I. Malmberg | Nurse Practitioner | 309 South Galena Ave, Suite 100, Dixon, IL 61021 | 2011-03-30 |
| 1376775262 | Kelly L Klein | Optometrist | 511 Palmyra Street, Ksb Eye & Vision Care, Dixon, IL 61021 | 2009-08-11 |
| 1013119106 | Michael Joseph Sarno | Physical Therapist | 401 E. First Street, Dixon, IL 61021 | 2007-06-01 |
| 1891905600 | Thomas G. Gehlbach | Internal Medicine | 215 E 1st St Ste 111, Dixon, IL 61021 | 2007-05-23 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| Find all providers in zip 61021 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619945037 | Lionel B Wong | Internal Medicine | 215 E 1st St, Ste 211, Dixon, IL 61021-3166 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013487388 | Endoscopy Center of The North Shore, LLC | Internal Medicine | 1100 Central Ave Ste H, Wilmette, IL 60091-2666 | 2018-11-29 |
| 1104303296 | Amanda Israel | Internal Medicine | 5841 S Maryland Ave # 4076m410, Chicago, IL 60637-1443 | 2018-07-23 |
| 1861999559 | Kiba, Inc. | Internal Medicine | 3845 Mccoy Dr Ste 101, Aurora, IL 60504-4429 | 2018-04-09 |
| 1447765888 | David Henoch Barch | Internal Medicine | 3431 N Leavitt St, Chicago, IL 60618-6013 | 2017-12-07 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1205218658 | Ye Eun Kwak | Internal Medicine | 5841 S Maryland Ave Rm J-517, Chicago, IL 60637 | 2015-06-22 |
| 1699186890 | Laura Hamad | Internal Medicine | 1717 Midwest Club Pkwy, Oak Brook, IL 60523-2586 | 2014-05-11 |
| 1154749042 | Joshua Michael Steinberg | Internal Medicine | 5841 S Maryland Ave # 4076, Chicago, IL 60637-1443 | 2014-03-28 |
| 1841533254 | Danish Shahab | Internal Medicine | 133 E Brush Hill Rd Ste 100&400, Elmhurst, IL 60126-5659 | 2013-04-03 |
| 1447599311 | Seymour Marshall Sabesin | Internal Medicine | 630 S Hermitage Ave, Suite 802, Chicago, IL 60612-3874 | 2013-02-12 |
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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.