The Ambrose Group, Inc

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

THE AMBROSE GROUP, INC

Practice address

328 W Sauk TRL
Frankfort, IL 60423-7778

Phone

(708) 721-1463

Fax

(708) 234-7133

NPI assigned

Feb 25, 2008

Organization subpart

No

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

Authorized official

Name

Mark Ambrose, PA

Title

Physician Asst. / Surgeon Asst.

Phone

(708) 721-1463

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203897600000",
    "number": "1790954725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 W SAUK TRL",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604237778",
            "telephone_number": "708-721-1463",
            "fax_number": "708-234-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 W SAUK TRL",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604237778",
            "telephone_number": "708-721-1463",
            "fax_number": "708-234-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE AMBROSE GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2008-02-25",
        "status": "A",
        "authorized_official_last_name": "AMBROSE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PHYSICIAN ASST. / SURGEON ASST.",
        "authorized_official_telephone_number": "708-721-1463",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; 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.