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Contact Information

ADVANCED SURGICAL TECHNOLOGY, LLC
4200 WILLIAMSON PL STE 1A
MOUNT VERNON, IL62864-6705
 Phone: 618-899-9200
 Fax: 618-899-9206
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for ADVANCED SURGICAL TECHNOLOGY LLC · (Female)

NPI # 1497159024
Status Active
Credentials
Entity Individual
Enumeration date 10/10/2014
Last updated 07/17/2019 - About 7 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 036115674
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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