Organization
ACE MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATRINA SMITH (ADMIN)
(219) 513-9019
Entity
Organization
Contact information
Practice address
929 RIDGECREST DR, BELLEVILLE, IL 62220-3163
(618) 340-3225
Mailing address
929 RIDGECREST DR, BELLEVILLE, IL 62220-3163
(618) 340-3225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
209011911
IL
363LF0000X
Family Nurse Practitioner
Primary
209011911
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209011911
—
IL
Enumeration date
04/07/2017
Last updated
04/07/2017
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