RICHARD FASSOLA (NPI# 1720331671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720331671 |
| Entity Type | Individual |
| Full Name | RICHARD FASSOLA |
| Credential | PA-C |
| Practice Address |
1932 S Main St Eureka IL 61530-1666 |
| Mailing Address |
5908 Greenview Rd Lisle IL 60532-2904 |
| Practice Telephone | 3094675000 |
| Practice Fax Number | 3094671500 |
| Mailing Telephone | 8154742678 |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2016-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085-000933 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1932 S MAIN ST |
| City | EUREKA |
| State | IL |
| Zip Code | 61530-1666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932161965 | Tamra Brisbin | Physician Assistant | 1932 S Main St, Eureka, IL 61530-1666 | 2006-04-05 |
| 1376085837 | Monica Malcome | Massage Therapist | 1932 S Main St, Eureka, IL 61530-1666 | 2016-11-14 |
| 1114472610 | Tarah Noel Gibbs | Nurse Practitioner | 1932 S Main St, Eureka, IL 61530-1666 | 2016-08-25 |
| 1881149219 | Stephanie Pasley | Nurse Practitioner | 1932 S Main St, Eureka, IL 61530-1666 | 2016-08-15 |
| 1235524620 | Jeffrey Daniel Schmidgall | Chiropractor | 1932 S Main St, Eureka, IL 61530-1666 | 2015-04-02 |
| 1801296108 | Amanda Catherine Wackt | Nurse Practitioner | 1932 S Main St, Eureka, IL 61530-1666 | 2014-08-25 |
| 1730594037 | Stephanie R Rinehart | Nurse Practitioner | 1932 S Main St, Eureka, IL 61530-1666 | 2014-06-25 |
| 1336554625 | Preferred Care Medical Center Ltd. | Chiropractor | 1932 S Main St, Eureka, IL 61530-1666 | 2014-06-25 |
| 1295080406 | Brett Lee Rappenecker | Chiropractor | 1932 S Main St, Eureka, IL 61530-1666 | 2012-07-14 |
| 1467698308 | Preferred Care Chiropractic Ltd | Chiropractor | 1932 S Main St, Eureka, IL 61530-1666 | 2008-12-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134464316 | Tazwood Mental Health Center, Inc. | Community/Behavioral Health | 101 S. Major Street, Eureka, IL 61530 | 2012-11-29 |
| 1508009234 | Woodford County | Substance Abuse Rehabilitation Facility | 105 E Court St, Eureka, IL 61530 | 2009-04-10 |
| 1609889914 | Apostolic Christian Home of Eureka | Skilled Nursing Facility | 610 W. Cruger St., Eureka, IL 61530 | 2006-08-15 |
| 1326003344 | Eric John Larson | Counselor | 109 E Eureka, Eureka, IL 61530 | 2006-04-20 |
| 1467789511 | Julie Tuttle | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61530 | 2009-11-11 |
| 1720073414 | Maple Lawn Health Center | Skilled Nursing Facility | 700 N Main St, Eureka, IL 61530-1085 | 2005-09-19 |
| 1992158356 | Kendra Mickelson | Skilled Nursing Facility | 700 N Main St, Eureka, IL 61530-1085 | 2016-07-20 |
| 1720439110 | Loft Rehabilitation and Nursing LLC | Skilled Nursing Facility | 700 N Main St, Eureka, IL 61530-1085 | 2016-06-27 |
| 1841470374 | Maple Lawn Homes Inc. | Clinic/Center | 700 N Main St, Eureka, IL 61530-1085 | 2007-11-13 |
| 1093818767 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 501 W Center St, Eureka, IL 61530-1111 | 2006-09-07 |
| Find all providers in zip 61530 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326490129 | Cory Heiser | Physician Assistant | 401 9th St Ste A, Eureka, SD 57437-2183 | 2016-07-06 |
| 1801243241 | Sarah Kingstrom | Physician Assistant | 2933 Pigeon Point Rd, Eureka, CA 95503 | 2016-05-16 |
| 1033487145 | Shubhangi B Deshmukh | Physician Assistant | 2725 Myrtle Ave, Eureka, CA 95501-3425 | 2011-12-03 |
| 1881783892 | Duane Duke Gibson | Physician Assistant | 250 S. Main Street, Eureka, NV 89316 | 2006-10-11 |
| 1417059445 | Miles Miller | Physician Assistant | 995 Hwy 93 S, Eureka, MT 59917 | 2006-09-01 |
| 1932161965 | Tamra Brisbin | Physician Assistant | 1932 S Main St, Eureka, IL 61530-1666 | 2006-04-05 |
| 1891780086 | Nancy J Mckenzie | Physician Assistant | 110 E 16th St, Eureka, KS 67045-1067 | 2005-09-14 |
| 1740284686 | Mary Catherine Silver | Physician Assistant | 2367 Harrison Ave, Eureka, CA 95501-3216 | 2005-06-09 |
| 1144868803 | Kirsten Elise Stambaugh | Physician Assistant | 2440 23rd St Ste B, Eureka, CA 95501-3203 | 2019-12-12 |
| 1457908204 | Emily Pauli | Physician Assistant | 200 J Ave Ste A, Eureka, SD 57437-2225 | 2019-08-26 |
| Find all providers in EUREKA | ||||
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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.