Organization
SOUTHERN ILLINOIS VASCULAR SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HANS HASSAN MOOSA M.D. (PRESIDENT)
(618) 233-2500
Entity
Organization
Contact information
Practice address
311 W LINCOLN ST, SUITE 200, BELLEVILLE, IL 62220-1902
(618) 233-2500
(618) 233-2520
Mailing address
311 W LINCOLN ST, SUITE 200, BELLEVILLE, IL 62220-1902
(618) 233-2500
(618) 233-2520
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
IL
Other
Enumeration date
10/10/2006
Last updated
08/22/2020
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