Elbert a Fasnacht II MD LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036075250 Issued in IL

Legal business name

ELBERT A FASNACHT II MD LTD

Practice address

721 South Lewis Lane
Carbondale, IL 62901-3344

Phone

(618) 457-4999

Fax

(618) 457-5099

NPI assigned

Oct 16, 2006

Last updated

Sep 10, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elbert Alvin Fasnacht II, MDNPI 1790834828

Title

President

Phone

(618) 457-4999

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elbert A Fasnacht II, MD

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1790834828
  Authorized official Same address or phone
• Christopher James Hanson, M.D., M.B.A

  • Family Medicine Physician
  • Carbondale, IL
  • NPI 1447514971
  NPD

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1962582700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 SOUTH LEWIS LANE",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013344",
            "telephone_number": "618-457-4999",
            "fax_number": "618-457-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 SOUTH LEWIS LANE",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013344",
            "telephone_number": "618-457-4999",
            "fax_number": "618-457-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELBERT A FASNACHT II MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "FASNACHT",
        "authorized_official_first_name": "ELBERT",
        "authorized_official_middle_name": "ALVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-457-4999",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036075250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "137121",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DP1138",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "027366",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036075250",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaile Jean Eggemeyer
• Abraham El-Sedfy, M.D.
• Samir Elabbadi
• Barb Grace Elam, LCPC
• David Allen Elam, PH.D.
• Elevate Therapy & Performance PC
• Salman Mahmoud Elgharbawy, MD
• Labib Elkahwaji, MD
• Emilie Joann Emberton
• Empowerme Rehabilitation Illinois, LLC

• Internal Medicine Physician in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.