David L Faulk, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

036 049209 Issued in IL

Practice address

1 E Countyline Rd
Sandwich, IL 60548-2178

Phone

(815) 786-2722

Fax

(815) 786-6840

NPI assigned

Aug 30, 2005

Last updated

Jan 9, 2009By the provider in NPPES

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

Not listed in the public Medicare enrollment file

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1760475271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E COUNTYLINE RD",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605482178",
            "telephone_number": "815-786-2722",
            "fax_number": "815-786-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E COUNTYLINE RD",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605482178",
            "telephone_number": "815-786-2722",
            "fax_number": "815-786-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036 049209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "1921614",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036049209",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy Lee Emma, COTA
• Erik David Englehart, M.D.
• Victor Robert Epperson, LCPC
• Erik Englehart MD Family Medicine LLC
• Jenise Ervin, FNP
• James Joseph Fedinec, M.D.
• First Impressions by Lerohl & Landers
• Latehesha Fitch, LCPC
• Katie Michelle Fitzgerald, PT
• Kara Flynn, DMD

• Colon & Rectal Surgery Physician in Sandwich, IL
• Providers in Sandwich, IL by specialty
• Colon & Rectal Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; 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.