Aric J Eckhardt, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

036099360 Issued in IL

Practice address

3900 28TH Ave Dr
Suite 105
Moline, IL 61265-5536

Phone

(309) 764-4650

Fax

(866) 633-1827

NPI assigned

Mar 1, 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 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1730156647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 28TH AVE DR",
            "address_2": "SUITE 105",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612655536",
            "telephone_number": "309-764-4650",
            "fax_number": "866-633-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 28TH AVE DR",
            "address_2": "SUITE 105",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612655536",
            "telephone_number": "309-764-4650",
            "fax_number": "866-633-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKHARDT",
        "first_name": "ARIC",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036099360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36099360",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "513138",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan A Durick, M.D.
• Anna Malgorzata Dymala, M.D.
• Earl G Gloeckner, M.D., LTD
• Alexander Earnest
• Ciara Echols
• Marian Lynn Edmund, COTA/L
• Eduardo a Millare MD SC
• Richard A Egger, D.D.S.
• Steven E Eilers
• Elizabeth E Temple MD LTD

• Plastic Surgery Physician in Moline, IL
• Providers in Moline, IL by specialty
• Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.