Provider Demographics
NPI:1790700920
Name:FESSLER, ALBERT JAMES III (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:JAMES
Last Name:FESSLER
Suffix:III
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-362-7845
Mailing Address - Fax:314-362-0296
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV NEUROLOGY EPILEPSY, STE 6C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-362-7845
Practice Address - Fax:314-362-0296
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230503472084N0400X, 2084E0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200136011Medicaid
NYRA6667Medicare PIN