Organization
ASSOCIATED PHYSICIANS GROUP LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN S VICK DO (OWNER)
(618) 628-8211
Entity
Organization
Contact information
Practice address
20 PROFESSIONAL PARK DR, SUITE A, MARYVILLE, IL 62062-5830
(618) 205-3655
Mailing address
916 TALON DR, SUITE 102, O FALLEN, IL 62269-1848
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811940893
BCBS
IL
Enumeration date
05/10/2012
Last updated
09/12/2012
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