Louis Thomas Distasio, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

198000025 Issued in IL

Practice address

716 S 2ND St.
Springfield, IL 62704

Phone

(217) 544-8118

Fax

(217) 544-8008

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1629153085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 S 2ND ST.",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62704",
            "telephone_number": "217-544-8118",
            "fax_number": "217-544-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 S 2ND ST.",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62704",
            "telephone_number": "217-544-8118",
            "fax_number": "217-544-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTASIO",
        "first_name": "LOUIS",
        "middle_name": "THOMAS",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198000025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8482034",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marian Dionne, L.C.P.C.
• Randy Dionne, L.C.P.C.
• Alicia M Dirksen, LMT
• Dispatch Medical Transport
• Nicole Renee Dissette, PMHNP-BC
• Mary Beth Ditman, C.F.N.P.
• Rebecca Dix, MD
• Lindsay Breanne Dixon, NP
• Diya Counseling Services, PLLC
• Rebecca Ann Dobbs

• Acupuncturist in Springfield, IL
• Providers in Springfield, IL by specialty
• Acupuncturist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.