Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eric A Kivisto, DO

Individual provider Surgery Physician · NPI 1447257316

Eric A Kivisto, DO is a General Surgery in Mendota, Illinois. Graduated from Chicago College of Osteopathy in 1989, 37 years ago. Practices with Crittenden Community Hospital LLC, a 20-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois and Michigan.

Years since qualifying
37
Trained at
Chicago College of Osteopathy
Licensed in
IL, MI
In the registry since
2005
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1405 E 12th St Ste 500
Mendota, IL 61342-9010
Phone: (815) 539-1789
Fax: (815) 539-1430
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 220 S Park Ave Fl 3, Herrin, IL 62948-3602 — (618) 942-2002

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 036091073 (IL)
Surgery Physician Taxonomy 208600000X · Licence 5101011210 (MI)

Record details

NPI number1447257316
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 6, 2005
Last updated in NPPESDecember 7, 2022
Certification dateDecember 7, 2022
Mailing address1401 E 12th St, Mendota, IL 61342-9216

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolCHICAGO COLLEGE OF OSTEOPATHY
Graduated 1989 (37 years in practice)
Group practice Crittenden Community Hospital Llc — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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