Kelly Ambrosius, CST,CFA,RSA | |
39067 N Caroline Ave, #362, Wadsworth, IL 60083-7728 | |
(800) 560-8374 | |
(800) 560-8374 |
Full Name | Kelly Ambrosius |
---|---|
Gender | Male |
Speciality | Physician Assistant - Surgical |
Location | 39067 N Caroline Ave, Wadsworth, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932322815 | NPI | - | NPPES |
61-1409473 | Other | IL | FEIN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363AS0400X | Physician Assistant - Surgical | 238.00009 (Illinois) | Primary |
Mailing Address | Practice Location Address |
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Kelly Ambrosius, CST,CFA,RSA Po Box 362, Wadsworth, IL 60083-0362 Ph: () - | Kelly Ambrosius, CST,CFA,RSA 39067 N Caroline Ave, #362, Wadsworth, IL 60083-7728 Ph: (800) 560-8374 |