Vamc

Primary specialty

VA Clinic/CenterTaxonomy code 261QV0200X

License

4301040401 Issued in IL

Legal business name

VAMC

Practice address

2401 W Main St
Marion, IL 62959-1188

Phone

(618) 997-5311

Fax

(618) 998-5661

NPI assigned

Jul 3, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mohammed Y Mansuri, MD

Title

Staffcardiologist

Phone

(618) 997-5311

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881623577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "618-997-5311",
            "fax_number": "618-998-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "618-997-5311",
            "fax_number": "618-998-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANSURI",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "STAFFCARDIOLOGIST",
        "authorized_official_telephone_number": "618-997-5311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "IL",
            "license": "4301040401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Scott Utley, RD, LDN
• VA Medical Center
• VA Medical Center
• Kalaya Kathy Valdez, DNP
• Jason L Vallette, CRNA
• Jason Matthew Van Sickle, LCSW, MSCS, COR
• Anne Vana, RN
• Janice Lynn Vance, RN
• Emily Vandonselaar
• Liudmila Vasilets, MD

• VA Clinic/Center in Marion, IL
• Providers in Marion, IL by specialty
• VA Clinic/Center 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.