KING CITY SURGERY CENTER, S.C. NPI 1003005463

Thoracic Surgery (Cardiothoracic Vascular Surgery) in Mount Vernon, IL

About KING CITY SURGERY CENTER, S.C.

King City Surgery Center, S.c. is a provider in Mount Vernon, IL. The NPI number assigned to this provider is 1003005463. The practitioner's primary taxonomy code is Thoracic Surgery (Cardiothoracic Vascular Surgery) (208G00000X). The provider is registered as an organization and their NPI record was last updated 10 years ago. King City Surgery Center, S.c. operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization.

NPI1003005463 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameKING CITY SURGERY CENTER, S.C.
Provider Location Address2605 MAIN ST MOUNT VERNON, IL 62864 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address2605 MAIN ST MOUNT VERNON, IL 62864 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date10-22-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date10-22-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

KING CITY SURGERY CENTER, S.C.
2605 MAIN ST
MOUNT VERNON, IL
ZIP 62864
Phone: (618) 244-0050
Fax: (618) 244-0061
Get Directions

Mailing Address

KING CITY SURGERY CENTER, S.C.
2605 MAIN ST
MOUNT VERNON, IL
ZIP 62864
Phone: (618) 244-0050
Fax: (618) 244-0061

Primary Taxonomy

Taxonomy Code208G00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationThoracic Surgery (Cardiothoracic Vascular Surgery)
TypeAllopathic & Osteopathic Physicians
License StateIL
Taxonomy DescriptionA thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

Authorized Official

Authorized Official NameDR. ANTON SCHITTEK M.D.,F.A.C.S. Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitlePHYSICIAN/PRESIDENT
Authorized Official Phone(618) 244-0050

193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1208600000XAllopathic & Osteopathic PhysiciansSurgeryILNo

Taxonomy Description: a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
A88218MEDICARE UPIN (02)IL
207132MEDICARE PIN (08)IL

Map Location


KING CITY SURGERY CENTER, S.C. address is 2605 MAIN ST MOUNT VERNON, IL 62864

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1053418780DR. ANTON SCHITTEK M.D.
Individual
Thoracic Surgery (Cardiothoracic Vascular Surgery)2605 MAIN ST
MOUNT VERNON, IL 62864
(618) 244-0050
1487645776 TOMASZ A KOSIERKIEWICZ X MD
Individual
Psychiatry & Neurology (Neurology)2605 MAIN ST
MOUNT VERNON, IL 62864
(618) 242-7350
1720079015MT VERNON NEUROLOGY, S.C.
Organization
Psychiatry & Neurology (Neurology)2605 MAIN ST
MOUNT VERNON, IL 62864
(618) 242-7350