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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

NPI # 1497159024
LBN Legal business name ADVANCED SURGICAL TECHNOLOGY, LLC
Authorized official SANDRA ADAMS - (OFFICE ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/10/2014
Last updated 07/17/2019 - About 7 years ago
Identifiers
IL License # 036115674
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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