Organization
HIGHLAND AMBULATORY SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH R THOMAE M.D. (PRESIDENT)
(618) 654-8100
Entity
Organization
Contact information
Practice address
1212 BROADWAY, SUITE C, HIGHLAND, IL 62249-1960
(618) 654-8100
(618) 654-4563
Mailing address
1212 BROADWAY, SUITE C, HIGHLAND, IL 62249-1960
(618) 654-8100
(618) 654-4563
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002868
IL
Other
Enumeration date
05/22/2006
Last updated
06/01/2010
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