Healthcare Provider Details

I. General information

NPI: 1801744719
Provider Name (Legal Business Name): MEC ADVANCED SURGICAL INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 W DEYOUNG ST
MARION IL
62959
US

IV. Provider business mailing address

1202 W DEYOUNG ST
MARION IL
62959
US

V. Phone/Fax

Practice location:
  • Phone: 618-967-1396
  • Fax:
Mailing address:
  • Phone: 618-967-1396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FAISEL AHMAD
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 618-967-1396