Healthcare Provider Details

I. General information

NPI: 1326488594
Provider Name (Legal Business Name): MOHSIN SALIH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2013
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MEMORIAL DR STE 122
ALTON IL
62002-6723
US

IV. Provider business mailing address

2 MEMORIAL DR STE 122
ALTON IL
62002-6723
US

V. Phone/Fax

Practice location:
  • Phone: 618-462-6612
  • Fax: 618-433-6793
Mailing address:
  • Phone: 618-462-6612
  • Fax: 618-433-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2013014388
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number2025032576
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number036.148621
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036148621
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: