Organization
ADVANCED HEART CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR ALMOUSALLI MD (OWNER)
(618) 222-8900
Entity
Organization
Contact information
Practice address
4600 MEMORIAL DR, W3, BELLEVILLE, IL 62226-5366
(618) 222-8900
(618) 222-8950
Mailing address
PO BOX 23140, BELLEVILLE, IL 62223-0140
(618) 222-8900
(618) 222-8950
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036097388
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360973885
—
IL
Enumeration date
09/17/2008
Last updated
01/08/2015
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