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Organization
SOUTHERN ILLINOIS VASCULAR SURGERY, PC
Active
Organization
SOUTHERN ILLINOIS VASCULAR SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HANS HASSAN MOOSA M.D. (PRESIDENT)
(618) 233-2500
Entity
Organization
Contact information
Practice address
311 W LINCOLN ST, SUITE 200, BELLEVILLE, IL 62220-1902
(618) 233-2500
(618) 233-2520
Mailing address
311 W LINCOLN ST, SUITE 200, BELLEVILLE, IL 62220-1902
(618) 233-2500
(618) 233-2520
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
IL
Other
Enumeration date
10/10/2006
Last updated
08/22/2020
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