Individual provider Active NPI

Salvatore Antonio Fanto, MD

  • Surgery of the Hand (Surgery) Physician
  • Orland Park, IL
National Provider Identifier
1053435222
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Surgery) PhysicianTaxonomy code 2086S0105X
License
036076529 Issued in IL
Practice address
11304 W Distinctive Drive
Orland Park, IL 60462
Phone
(708) 479-0005
Fax
(708) 479-0022
NPI assigned
Mar 16, 2007
Last updated
Apr 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Surgery) Physician 2086S0105X 036076529 IL Primary

Addresses

Primary practice location

11304 W Distinctive Drive
Orland Park, IL 60462

Mailing address

PO Box 2087
Orland Park, IL 60462
Phone (708) 364-0075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101011000495 IL Practitioner - Hand Surgery 4880886753 Practice locations: Orland Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Hand Surgery
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11304 Distinctive Dr
Orland Park, IL 60467-9459
Phone (708) 364-0075

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision19
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1053435222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2087",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "60462",
            "telephone_number": "708-364-0075",
            "fax_number": "708-364-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11304 W DISTINCTIVE DRIVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "60462",
            "telephone_number": "708-479-0005",
            "fax_number": "708-479-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTO",
        "first_name": "SALVATORE",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "IL",
            "license": "036076529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.