SOUTHERN ILLINOIS VASCULAR SURGERY PC NPI 1407944192

NPI Information

SOUTHERN ILLINOIS VASCULAR SURGERY, PC is a vascular surgery surgery in Belleville, IL. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. SOUTHERN ILLINOIS VASCULAR SURGERY, PC NPI is 1407944192. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

311 W LINCOLN ST
SUITE 200
BELLEVILLE, IL
ZIP 62220-902
Phone: (618) 233-2500
Fax: (618) 233-2520

The provider's authorized official is Hans Hassan Moosa .
The authorized official title is President and has the following contact phone number (618) 233-2500.

The enumeration date for this NPI number is 10/10/2006 and was last updated on 8/22/2020.

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:

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