Associated Physicians Group LTD

Organization Active NPI Physician Assistant · Waterloo, IL

NPI 1346784675 · NPPES record last updated Dec 6, 2016

Key facts

NPI
1346784675
Entity type
Organization (NPI type 2)
Primary specialty
Physician Assistant 363A00000X
License
085.005551 (IL)
Legal business name
ASSOCIATED PHYSICIANS GROUP LTD
Practice address
509 Hamacher St
Suite 202
Waterloo, IL 62298-1592
Phone
(618) 939-5979
Fax
(618) 939-5984
NPI assigned
Dec 6, 2016
Organization subpart
No

Authorized official

Name
Renee L Carson
Title
Credentialing Specialist
Phone
(618) 628-8211

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Associated Physicians GRP (5 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363A00000X 085.005551 IL Yes

Addresses

Primary practice location

509 Hamacher St
Suite 202
Waterloo, IL 62298-1592

Mailing address

916 Talon Dr
Suite 102
O Fallon, IL 62269-1848
Phone (618) 628-8211

Other providers in Waterloo, IL

All providers in Waterloo, IL · Physician Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.