NPIMap

Individual provider Active NPI

Erik Christian Stabell, MD

  • Internal Medicine Physician
  • Alton, IL
National Provider Identifier
1609868108
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-069182 Issued in IL
Practice address
1 Professional Dr
Suite 220
Alton, IL 62002-5068
Phone
(618) 463-8610
Fax
(618) 463-8688
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 036-069182 IL
Infectious Disease Physician 207RI0200X R6N20 MO
Internal Medicine Physician 207R00000X 036-069182 IL Primary

Addresses

Primary practice location

1 Professional Dr
Suite 220
Alton, IL 62002-5068

Mailing address

1 Professional Dr Suite 220
Alton, IL 62002-5068
Phone (618) 463-8500

Other identifiers 3

IdentifierTypeStateIssuer
036069182MedicaidIL
207945908MedicaidMO
207219OtherILPTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040129000845 IL Practitioner - Internal MedicinePractitioner - Infectious Disease 6608779350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Rush Medical College of Rush University, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians
Empowerme Rehabilitation Illinois LLCGroup PAC ID 2365718277, shared by 6 NPIs, 361 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

1 Professional Dr
Alton, IL 62002-5068

7108 Marine Rd
Edwardsville, IL 62025-4282
Phone (618) 706-9759

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-069182ILMDInternal Medicine Physician
R6N20MOMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Apr 1, 2024 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Apr 1, 2024 Accepting new patients
Midwest Acute Care Consultants, PC Infectious Disease Past Accepting new patients
Christian Hospital Physician Billing Services LLC Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

1 Professional Dr
Ste 120
Alton, IL 62002
Phone (618) 463-7800

1 Professional Dr
Ste 220
Alton, IL 62002
Phone (618) 463-8610

1 Professional Dr
Alton, IL 62002
Phone (618) 463-8660

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6433

660 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 463-6950

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1609868108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PROFESSIONAL DR SUITE 220",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025068",
            "telephone_number": "618-463-8500",
            "fax_number": "618-463-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PROFESSIONAL DR",
            "address_2": "SUITE 220",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025068",
            "telephone_number": "618-463-8610",
            "fax_number": "618-463-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STABELL",
        "first_name": "ERIK",
        "middle_name": "CHRISTIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036-069182",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "R6N20",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-069182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069182",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207945908",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "207219",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1 Professional Dr",
            "address_2": "Suite 220",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620025068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.