Active NPI
Linda Redick, P.A.
- Physician Assistant
- Eldorado, IL
National Provider Identifier
1922259993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085001829
- Practice address
- 1306 Maple St
Eldorado, IL 62930-1662 - Phone
- (618) 297-9665
- Fax
- (618) 273-5839
- NPI assigned
- Oct 8, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085001829 | IL | Primary |
Addresses
Primary practice location
1306 Maple St
Eldorado, IL 62930-1662
Mailing address
1306 Maple St
Eldorado, IL 62930-1662
Phone (618) 297-9665
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386115200000",
"number": "1922259993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1306 MAPLE ST",
"city": "ELDORADO",
"state": "IL",
"postal_code": "629301662",
"telephone_number": "618-297-9665",
"fax_number": "618-273-5839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1306 MAPLE ST",
"city": "ELDORADO",
"state": "IL",
"postal_code": "629301662",
"telephone_number": "618-297-9665",
"fax_number": "618-273-5839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDICK",
"first_name": "LINDA",
"name_prefix": "Mrs.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-08",
"last_updated": "2013-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085001829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eldorado, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.