Kelly Ambrosius is a Surgical in Wadsworth, Illinois. Kelly Ambrosius practices all healthcare services and medical treatments related to Surgical. The NPI Number for Kelly Ambrosius is 1932322815. The last update date is 2015-04-01.
Kelly Ambrosius's current location address is 39067 N Caroline Ave, Wadsworth, Illinois. You can contact this provider via phone number 8005608374 and fax number 8005608374. The mailing address for Kelly Ambrosius is 39067 N Caroline Ave, Wadsworth, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kelly Ambrosius |
|---|---|
| Address | 39067 N Caroline Ave, Wadsworth, Illinois |
| Phone Number | 8005608374 |
| Fax Number | 8005608374 |
| Sole Proprietor | N |
| Credentials | CST,CFA,RS |
NPI Number Detail
| NPI Number | 1932322815 |
|---|---|
| Provider Enumeration Date | 2007-04-10 |
| Last Updated Date | 2015-04-01 |
Provider Mailing Address Detail
| Address | 39067 N Caroline Ave |
|---|---|
| City | Wadsworth |
| State | Illinois (IL) |
| Post Code | 600837728 |
| Phone Number | 8005608374 |
| Fax Number | 8005608374 |
Provider's Primary Taxonomy Detail
| Speciality | Surgical |
|---|---|
| Taxonomy | 363As0400X |
| Licence No | 238.00009 |
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Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 61-1409473 | IL | FEIN |
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What is the unique identifier code issued to Kelly Ambrosius by the Centers for Medicare & Medicaid Services (CMS)?
The Kelly Ambrosius has been assigned the NPI (National Provider Identifier) 1932322815. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Kelly Ambrosius located?
The Kelly Ambrosius is located at 39067 N Caroline Ave, Wadsworth, IL 600837728.
What is Kelly Ambrosius's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Kelly Ambrosius's specialized field of practice is Surgical, and the corresponding taxonomy code that categorizes this area of specialization is 363As0400X.
On what date did the Kelly Ambrosius receive the assignment of its 1932322815 from the Centers for Medicare & Medicaid Services?
The Kelly Ambrosius was issued its 1932322815 by the Centers for Medicare & Medicaid Services on 2007-04-10.
When was the Kelly Ambrosius's information last updated?
The Kelly Ambrosius's information was last updated on 2015-04-01.