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 established in Mount Vernon, Illinois specializing in thoracic surgery (cardiothoracic vascular surgery). The NPI number of King City Surgery Center, S.c. is 1003005463 and was assigned on October 2007. The practitioner's primary taxonomy code is 208G00000X. The provider is registered as an organization and their NPI record was last updated 13 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. The authorized official of this NPI record is Dr. Anton Schittek M.d.,f.a.c.s. (Physician/president)
| NPI | 1003005463 |
| Provider Name | KING CITY SURGERY CENTER, S.C. |
| Provider Location Address | 2605 MAIN ST MOUNT VERNON, IL 62864 |
| Provider Mailing Address | 2605 MAIN ST MOUNT VERNON, IL 62864 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Enumeration Date | 10-22-2007 |
| Last Update Date | 10-22-2007 |
Primary Taxonomy
| Taxonomy Code | 208G00000X |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Type | Allopathic & Osteopathic Physicians |
| License State | IL |
| Taxonomy Description | A 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. |
Business Address
KING CITY SURGERY CENTER, S.C.
2605 MAIN ST
MOUNT VERNON, IL
ZIP 62864
Phone: (618) 244-0050
Fax: (618) 244-0061
Mailing Address
KING CITY SURGERY CENTER, S.C.
2605 MAIN ST
MOUNT VERNON, IL
ZIP 62864
Phone: (618) 244-0050
Fax: (618) 244-0061
Group Taxonomy
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 |
|---|---|---|---|---|---|---|---|
| 1 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | IL | No | ||
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 |
|---|---|---|
| A88218 | MEDICARE UPIN (02) | IL |
| 207132 | MEDICARE PIN (08) | IL |
Other Providers at the same location
The following 3 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1053418780 | DR. 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 |
| 1720079015 | MT VERNON NEUROLOGY, S.C. Organization | Psychiatry & Neurology (Neurology) | 2605 MAIN ST MOUNT VERNON, IL 62864 (618) 242-7350 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider 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 Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type 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)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart 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.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary 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.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.