Organization
MERCY CLINIC SURGICAL SPECIALISTS-ILLINOIS LLC
Active
Parent organization
MERCY CLINIC EAST COMMUNITIES
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERCY CLINIC EAST COMMUNITIES
Authorized official
KERRY DUNGER (EXECUTIVE DIRECTOR - FINANCE)
(314) 364-3707
Entity
Organization
Contact information
Practice address
2227 VADALABENE DR STE 200, MARYVILLE, IL 62062-5824
(618) 288-2052
Mailing address
2227 VADALABENE DR STE 200, MARYVILLE, IL 62062-5824
(618) 288-2052
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500052754
—
MO
Enumeration date
03/16/2018
Last updated
04/28/2025
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