Sandra L Fallico

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036077396 Issued in IL

Practice address

800 Biesterfield Rd
Elk Grove Radiology
Elk Grove VLG, IL 60007-3311

Phone

(847) 956-5124

Fax

(847) 952-7912

NPI assigned

Jun 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1831139823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "ELK GROVE RADIOLOGY",
            "city": "ELK GROVE VLG",
            "state": "IL",
            "postal_code": "600073311",
            "telephone_number": "847-956-5124",
            "fax_number": "847-952-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "ELK GROVE RADIOLOGY",
            "city": "ELK GROVE VLG",
            "state": "IL",
            "postal_code": "600073311",
            "telephone_number": "847-956-5124",
            "fax_number": "847-952-7912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLICO",
        "first_name": "SANDRA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036077396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Lis O.D.S.C.
• Felecia Katherine Dus
• Felisha Ann Edwards
• Lindsey Eilers, MA
• Elk Grove Internists, P.C.
• Family Medical Clinic, Inc.
• Gissel Ferrer
• Sabrina Gutierrez
• Head and Neck Associates 2 S C
• Healthier Behavior Therapy Solutions

• Diagnostic Radiology Physician in Elk Grove VLG, IL
• Providers in Elk Grove VLG, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.