person
Kelly Ambrosius, CST,CFA,RSA
Surgical Physician Assistant in Wadsworth, Illinois
NPI 1932322815

Kelly Ambrosius is a Surgical Physician Assistant based in Wadsworth, IL and is specialized in Surgical. Kelly Ambrosius practices in Wadsworth, IL and has the professional credentials of CST,CFA,RSA. The NPI Number for Kelly Ambrosius is 1932322815 and holds a License No. 238.00009 (Illinois).

The current practice location address for Kelly Ambrosius is 39067 N Caroline Ave, Wadsworth, IL and can be reached out via phone at 800-560-8374 and via fax at 800-560-8374.

Location: 39067 N Caroline Ave, Wadsworth, IL, 60083-0362
person
Provider Profile Details
NPI Number
1932322815
Provider Name
Kelly Ambrosius
Credential
CST,CFA,RSA
Provider Entity Type
Individual
Gender
Male
Address
39067 N Caroline Ave, Wadsworth, IL, 60083-0362
Phone Number
800-560-8374
Fax Number
800-560-8374
Provider Enumeration Date
04/10/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
61-1409473 01 IL FEIN
institution
Provider Business Practice Location Address Details
Address
39067 N Caroline Ave
City
State
Zip
60083-7728
Phone Number
800-560-8374
Fax Number
800-560-8374
person
Provider Business Mailing Address Details
Address
39067 N Caroline Ave
City
State
Zip
60083-7728
Phone Number
800-560-8374
Fax Number
800-560-8374
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
238.00009 (Illinois)
Definition
Definition to come...
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