Sean Fadale, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

70014050 Issued in IL

Practice address

810 W Anthony Dr
Urbana, IL 61802-7431

Phone

(217) 326-1911

Fax

(217) 344-8047

NPI assigned

Aug 31, 2007

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1649464736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK",
            "city": "RANTOUL",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-326-2911",
            "fax_number": "217-344-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W ANTHONY DR",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618027431",
            "telephone_number": "217-326-1911",
            "fax_number": "217-344-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADALE",
        "first_name": "SEAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "70014050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONALCARE PROVIDER #",
            "identifier": "7216",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "203",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROVIDER #",
            "identifier": "113326",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAMP PROVIDER #",
            "identifier": "4117",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael A Espino Carrera
• Steven W Etcheson, CRNA
• Elizabeth M Evans, DPT, ATC
• Evolution Counseling Center, P.C.
• Evolve Counseling Services, Inc.
• Anne Fahnestock, PT
• Victoria Oluwakemi Famuyide, DO
• Danielle Fanning, OT
• Kristen Emily Farney, MSN, RN, NE-BC
• James F Faron, OD

• Physical Therapist in Urbana, IL
• Providers in Urbana, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.