Victor L. Ambrosia, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-000853 Issued in IL

Practice address

800 W Central Rd
Arlington Heights, IL 60005-2349

Phone

(847) 618-3040

Fax

(847) 618-3049

NPI assigned

Jul 17, 2006

Last updated

Jan 14, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1811915952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 SALEM LAKE DR",
            "address_2": "SUITE F",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600475292",
            "telephone_number": "847-719-2220",
            "fax_number": "847-719-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W CENTRAL RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052349",
            "telephone_number": "847-618-3040",
            "fax_number": "847-618-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSIA",
        "first_name": "VICTOR",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-000853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.