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KING CITY SURGERY CENTER S.C. NPI 1003005463


NPI Information

NPI: 1003005463
Provider Name: KING CITY SURGERY CENTER, S.C.
Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Organization
Address:
2605 MAIN ST
MOUNT VERNON, IL
ZIP 62864
Phone: (618) 244-0050
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KING CITY SURGERY CENTER, S.C. is a thoracic surgery cardiothoracic vascular surgery in Mount Vernon, IL. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. KING CITY SURGERY CENTER, S.C. NPI is 1003005463. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2605 MAIN ST
MOUNT VERNON, IL
ZIP 62864-372
Phone: (618) 244-0050
Fax: (618) 244-0061

The provider's authorized official is Anton Schittek .
The authorized official title is Physician/president and has the following contact phone number (618) 244-0050.

The enumeration date for this NPI number is 10/22/2007 and was last updated on 10/22/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgeryILLINOISNo
2208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A88218MEDICARE UPINILLINOIS
2207132MEDICARE PINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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