Organization
ADVANCED EMERGENCY SPECIALISTS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A KLEIN MD (MEDICAL DIRECTOR)
(309) 691-5573
Entity
Organization
Contact information
Practice address
695 N KELLOGG ST, EMERGENCY DEPT., GALESBURG, IL 61401-2807
(309) 343-8131
Mailing address
4301 N STAR WAY, MODESTO, CA 95356-9262
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04832042
BLUE SHIELD
IL
Enumeration date
06/21/2007
Last updated
09/30/2008
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