Organization
SOUTHERN ILLINOIS HEART AND VASCULAR CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FADI MICHEL SHAMSHAM M.D. (PRESIDENT)
(941) 735-8419
Entity
Organization
Contact information
Practice address
4115 SOUTH WATER TOWER PLACE, MT. VERNON, IL 62864-6293
(941) 735-8419
Mailing address
P.O.BOX 1003, MT. VERNON, IL 62864-6293
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036123701
IL
Other
Enumeration date
07/13/2009
Last updated
07/13/2009
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