# PHYSICIANS SURGICAL CENTER, LLC

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

## Provider details

- **NPI number:** 1972548626
- **Authorized official:** MR. JOHN C WILSON JR. (CFO)
- **Authorized official phone:** (615) 346-4100

## Contact information

- **Practice address:** 311 W LINCOLN ST, STE. 300, BELLEVILLE, IL 62220-1902
- **Practice address phone:** (618) 233-7077
- **Practice address fax:** (618) 233-2814
- **Mailing address:** 311 W LINCOLN ST, STE. 300, BELLEVILLE, IL 62220-1902
- **Mailing address phone:** (618) 233-7077
- **Mailing address fax:** (618) 233-2814

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 042-006796 | IL | Yes |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 05/04/2012