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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RICHARD FASSOLA, PA-C

Active

RICHARD FASSOLA, PA-C is a Physician Assistant healthcare provider located in EUREKA, Illinois. NPI 1720331671 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · EUREKA, IL

Registration Details

NPI Number
1720331671
Provider Type
Individual
Gender
Male
NPI Issued
Oct 16, 2012 (13.806698406007 yrs)
Last Updated
Jun 15, 2016
License
085-000933 (IL)

Practice Information

Address
1932 S MAIN ST
EUREKA, IL, 615301666
Browse IL providers · Browse ZIP 61530
Phone
3094675000
Fax
3094671500
Primary Specialty
Physician Assistant
363A00000X

Other Physician Assistant Providers in EUREKA, IL

Name Credential NPI
TAMRA BRISBIN PA 1932161965
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.