Southern Illinois Vascular Surgery, PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

SOUTHERN ILLINOIS VASCULAR SURGERY, PC

Practice address

311 W Lincoln St
Suite 200
Belleville, IL 62220-1902

Phone

(618) 233-2500

Fax

(618) 233-2520

NPI assigned

Oct 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Hans Hassan Moosa, M.D.NPI 1194768432

Title

President

Phone

(618) 233-2500

Specialties & licenses 1

Addresses

Practitioners 2

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

• Hans Hassan Moosa, M.D.

  • Vascular Surgery Physician
  • Belleville, IL
  • NPI 1194768432
  NPD (past) Authorized official
• Donald P Spadone, MD

  • Vascular Surgery Physician
  • Oklahoma City, OK
  • NPI 1114935434
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407944192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W LINCOLN ST",
            "address_2": "SUITE 200",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201902",
            "telephone_number": "618-233-2500",
            "fax_number": "618-233-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W LINCOLN ST",
            "address_2": "SUITE 200",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201902",
            "telephone_number": "618-233-2500",
            "fax_number": "618-233-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS VASCULAR SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOOSA",
        "authorized_official_first_name": "HANS",
        "authorized_official_middle_name": "HASSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-233-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Illinois Oral & Maxillofacial Surgery, LTD.
• Southern Illinois Otolaryngology, LTD
• Southern Illinois Physician Services, PC
• Southern Illinois Pulmonary Consultants, LTD.
• Southern Illinois Surgical Appliance Co
• Southwestern Illinois College
• Southwestern Illinois College Programs for Older Psreons
• Lezah Spala, MS
• James E Spalding, CRNA
• Kimberly A Spano, FNP-BC

• Vascular Surgery Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Vascular Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.