# THE AMBROSE GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790954725
- **Authorized official:** MARK AMBROSE PA (PHYSICIAN ASST. / SURGEON ASST.)
- **Authorized official phone:** (708) 721-1463

## Contact information

- **Practice address:** 328 W SAUK TRL, FRANKFORT, IL 60423-7778
- **Practice address phone:** (708) 721-1463
- **Practice address fax:** (708) 234-7133
- **Mailing address:** 328 W SAUK TRL, FRANKFORT, IL 60423-7778
- **Mailing address phone:** (708) 721-1463
- **Mailing address fax:** (708) 234-7133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | IL | Yes |

## Other

- **Enumeration date:** 02/25/2008
- **Last updated:** 02/25/2008