Carmicheal LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036.127381 Issued in IL

Legal business name

CARMICHEAL LLC

Practice address

8601 West Main St.
Ste. 101
Belleville, IL 62223

Phone

(618) 398-6266

NPI assigned

Oct 12, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Crystal Carmicheal, MD

Title

President

Phone

(618) 398-6266

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342569600000",
    "number": "1861777690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 WEST MAIN ST.",
            "address_2": "STE. 101",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62223",
            "telephone_number": "618-398-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 WEST MAIN ST.",
            "address_2": "STE. 101",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "62223",
            "telephone_number": "618-398-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARMICHEAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-12",
        "last_updated": "2012-07-18",
        "status": "A",
        "authorized_official_last_name": "CARMICHEAL",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-398-6266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "036.127381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.