Alec Eshelman, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009677 Issued in IL

Practice address

374 E Grand Ave
Carbondale, IL 62901-3962

Phone

(618) 453-5371

NPI assigned

Dec 12, 2017

Sex

Male

Sole proprietor

Yes

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 Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Platteville Family Resource Center

  • Mental Illness Community Based Residential Treatment Facility
  • Platteville, WI
  • NPI 1104207497
  NPD (past)

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1992210975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11639 W CYPRESS DR",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629010721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 E GRAND AVE",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013962",
            "telephone_number": "618-453-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESHELMAN",
        "first_name": "ALEC",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Labib Elkahwaji, MD
• Emilie Joann Emberton
• Empowerme Rehabilitation Illinois, LLC
• Richard Lan England, M.D.
• Cynthia Ann Epplin, CRNA
• Eric Eskioglu, MD
• Katherine L Essary, LPN/RRT
• Erin Leigh Etheridge-Bagley, CNM
• Matthew Etherington, DO
• Dave Scott Evans, MS, CADC

• Clinical Psychologist in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.