Physicians Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

042-006796 Issued in IL

Legal business name

PHYSICIANS SURGICAL CENTER, LLC

Practice address

311 W Lincoln St
Ste. 300
Belleville, IL 62220-1902

Phone

(618) 233-7077

Fax

(618) 233-2814

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John C Wilson Jr.

Title

Cfo

Phone

(615) 346-4100

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Kosit Prieb, M.D.

  • Vascular Surgery Physician
  • Belleville, IL
  • NPI 1033154190
  NPD (past)

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1972548626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W LINCOLN ST",
            "address_2": "STE. 300",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201902",
            "telephone_number": "618-233-7077",
            "fax_number": "618-233-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W LINCOLN ST",
            "address_2": "STE. 300",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201902",
            "telephone_number": "618-233-7077",
            "fax_number": "618-233-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "615-346-4100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "042-006796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371267690001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eileen Peton-Thornton, SLP
• Christine Elizabeth Petteway, AU.D., CCC-A
• David Nelson Pfohl, MD, FACP, GAQ
• Kevin K Pham, DO
• Mary Edith Phelps, PTA
• Physicians' Surgical Center LLC
• Michelle Pickering, PT
• Frank Pikul, M.D.
• Kenneth C Pinkerton, DMD
• Tracie Leigh Placher

• Ambulatory Surgical Clinic/Center in Belleville, IL
• Providers in Belleville, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.