Ambrosius, Kelly

Ambrosius, Kelly is an individual health care provider with primary practice located at 39067 N Caroline Ave #362, Wadsworth IL 60083-7728. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Ambrosius, Kelly can be contacted via phone (800) 560-8374.

Contact Information

Primary practice address
39067 N Caroline Ave #362 Wadsworth IL 60083-7728
Phone: (800) 560-8374
Fax: (800) 560-8374
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 238.00009 Illinois

Profile Details

NPI number 1932322815
LBN Legal business name Ambrosius, Kelly
Credentials CST,CFA,RSA
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2007
Last updated Apr 1st, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1932322815 NPPES
Illinois Other 61-1409473 FEIN

Popular Providers