| Medical Surgical Clinic | |
|
5003 N Illinois St Ste 2 Fairview Heights IL 62208-3419 | |
| (618) 233-5000 | |
| (618) 233-5040 |
| Full Name | Medical Surgical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 5003 N Illinois St Ste 2, Fairview Heights, Illinois |
| Authorized Official Name and Position | Shabbir A Shaikh (PRESIDENT) |
| Authorized Official Contact | 6182335000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Surgical Clinic 5003 N Illinois St Ste 2 Fairview Heights IL 62208-3419 Ph: (618) 233-5000 | Medical Surgical Clinic 5003 N Illinois St Ste 2 Fairview Heights IL 62208-3419 Ph: (618) 233-5000 |
| NPI Number | 1679599104 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 10/15/2024 |
| Medicare PECOS PAC ID | 9133216476 |
|---|---|
| Medicare Enrollment ID | O20071102000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679599104 | NPI | - | NPPES |
| 0008215157 | Other | IL | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shabbir A Shaikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053337568 PECOS PAC ID: 5294822532 Enrollment ID: I20071102000160 |
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