| Richard Fassola, PA-C | |
|
1932 S Main St, Eureka, IL 61530-1666 | |
| (309) 467-5000 | |
| (309) 467-1500 |
| Full Name | Richard Fassola |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 1932 S Main St, Eureka, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720331671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 085-000933 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Fassola, PA-C 5908 Greenview Rd, Lisle, IL 60532-2904 Ph: (815) 474-2678 | Richard Fassola, PA-C 1932 S Main St, Eureka, IL 61530-1666 Ph: (309) 467-5000 |
Tamra Brisbin, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1932 S Main St, Eureka, IL 61530 Phone: 309-467-5000 Fax: 309-467-5100 | |
Alexandra Cessna Farmer, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 105 S Major St, Eureka, IL 61530 Phone: 309-467-4691 |