Elisa Skadahl, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010160 Issued in IL

Practice address

659 Knox Square Dr
Galesburg, IL 61401-8605

Phone

(309) 343-6870

Fax

(309) 343-6899

NPI assigned

Aug 18, 2008

Last updated

Aug 18, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219017600000",
    "number": "1568619898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 KNOX SQUARE DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614018605",
            "telephone_number": "309-343-6870",
            "fax_number": "309-343-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 KNOX SQUARE DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614018605",
            "telephone_number": "309-343-6870",
            "fax_number": "309-343-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKADAHL",
        "first_name": "ELISA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Siemers
• Cynthia Siever, IBCLC
• Amanda B Silberer
• Brittany S Simmons, PA-C
• Patricia A Simpson, RN
• Roger D. Sloan, M.D.
• Caitlin Clare Smith, OT
• Patrick Smith, P.T.
• Shelby Smith, MPT
• Solvera Healthcare Center Inc (Solvera Pharmacy)

• Optometrist in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.